Cardiovascular diseases in European ethnic minorities: Beyond the traditional cardiovascular risk factors

Abstract

This editorial is intended to be a reflection on cardiovascular disease (CVD) burden in European ethnic minorities. In some European countries, ethnic minority realities, due to their recent appearance, are still to be studied in depth. The experience of several European countries, where the migration processes started earlier, even more than a century ago, can help by being an example. Many studies have shown that major differences in CVD burden exist not only between countries, but also within the same country when considering different social strata and ethnic groups. The CV risk factors underlying heart disease have been well established. Important epidemiological studies have helped us understand that the underlying causes of heart disease as well as the behaviors that can help prevent them are the same. We are now well aware that CVD should be treated by considering a holistic approach. This is why the social determinants (SDs) of health that may worsen the disease burden or that, vice versa, may improve the treatment, and even more significantly, the prognosis of a patient’s illness should be taken into consideration. For ethnic minority patients, this holistic, hermeneutic approach is of importance. Several SDs of health that influence CVDs have been identified but their relevance for the health of ethnic minorities has not yet been clearly defined. In some European countries, most ethnic minorities are largely also religious minorities. Only a few studies have evaluated the role of religion, which is an important SD that affects the probability of having CV risk factors and diseases. Adolescents, particularly those belonging to the second generation, seem to be the weak link. If we believe that these young people are really citizens of their country of birth, then a way of recognizing their belonging to the community starts from a will to better understand their condition, in order to assist them while they grow physically and mentally. Thinking about safeguarding the health of this population should be more than a health task, rather a goal of social justice.

Keywords: Cardiovascular diseases; Cardiovascular risk factors; European ethnic minorities; Social determinants of health

Core Tip: A wealth of data highlight the existence of important differences in cardiovascular (CV) disease burden within the same country, when considering different social strata and ethnic groups. Both CV diseases and risk factors have been shown to be related to several social determinants of health. Thus, in ethnic minority individuals, a holistic, hermeneutic approach should be considered.