This paper first reviews the types of explanations that have been used in analyzing unequal distribution in coronary heart disease among different groups and changes in prevalence over time.
The explanations have mostly focused on the individual: individual behaviors, personalities, stressors, or social ties.
It is suggested here that a shift in focus to community-level characteristics may also aid in understanding changes in mortality.
Data are presented from Roseto, PA-a town that became known in the 1960's for its strong Italian traditions and very low mortality from myocardial infarction and that subsequently experienced a sharp rise in mortality-and from the adjacent comparison town of Bangor.
Mots-clés Pascal : Mortalité, Cardiopathie coronaire, Changement social, Epidémiologie, Structure sociale, Homme, Pennsylvanie, Etats Unis, Amérique du Nord, Amérique, Aspect social, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Mortality, Coronary heart disease, Social change, Epidemiology, Social structure, Human, Pennsylvania, United States, North America, America, Social aspect, Cardiovascular disease
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Code Inist : 002B12A03. Création : 199406.