Broadening Our Understanding of Survival After Myocardial Infarction The Association of Neighborhood With Outcomes

摘要: As clinicians and scientists, it is common to presume that clinical outcomes after myocardial infarction (MI) are most profoundly influenced by the pathogenesis of disease itself, including genetics, cardiovascular risk factors, inflammatory state, severity (eg, number obstructed coronary arteries), treatments we offer. Consequently, our efforts optimize patients aimed at following guidelines in care for individual patients.1–3 When profession seeks influence systems public policy, focus has been on increasing access lifesaving therapies.4 Because they appear outside physicians’ locus control, factors related patients’ socioeconomic status often not considered targets intervention. Article see p 375 Although numerous studies have defined an adverse association between lower post-MI treatment5 outcomes,6–8 little work done develop interventions overcome these disparities. We also sought systematically understand mediating may prognostic associations with outcomes. The reasons there such progress overcoming barriers, despite national priorities create equity health care,9–11 multifactorial include both difficulties measuring challenges them. In a critical review science linking outcomes, Braveman colleagues12 demonstrated different measures interchangeable, …