Social Capital and Cardiac Rehabilitation. Social Variation of Lifestyles of Men from Contrasting Socioeconomic Groups

Abstract

Social inequalities in health have been well documented in the literature. Despite the universal health care system and detailed measures of health surveillance, socioeconomic disparities related to cardiovascular diseases (CVD) remain present and are predicted to increase due to growing socioeconomic inequalities (Pampalon, 2008). Many health policy initiatives, such as the development of cardiac rehabilitation programs, were put in place in order to promote heart healthy lifestyles. These programs are provided as a medical and educational solution to prevent, manage, and lower risks of developing complications due to cardiovascular diseases, yet participation rates are as low as 37% for eligible individuals (Heart and Stroke Foundation of Canada, 2013). By drawing chiefly on Pierre Bourdieu’s sociocultural theory of practices, this qualitative study aims to understand the social variation of lifestyles in the context of cardiac rehabilitation of two groups of men from contrasting socioeconomic conditions. Sixty in-depth interviews were conducted with francophone men (mean age of 56.5) from the Outaouais region (Québec, Canada) who have suffered from a cardiac event requiring hospitalization. A number of studies on cardiovascular health have indicated health and lifestyle disparities among the male population. In order to provide a new perspective, this specific study drew principally on the notion of social capital in order to provide a more complete understanding of the social variation of lifestyles in the context of cardiac rehabilitation, particularly the impact these socioeconomic differences have on the quality of participants’ social capital, and how it shapes lifestyles after a heart intervention The results of this study are presented in an article which compares lifestyles and cardiac rehabilitation practices on the basis of three concepts of social capital, – social cohesion, trust, and social support. Results suggests that socioeconomic conditions influence levels of social cohesion, trust, and the quality of social support provided by social networks in the context of cardiac rehabilitation. Despite the underprivileged participant’s awareness of normative health lifestyles, they also were constrained by socio-cultural barriers, which limited a heart-healthy lifestyle.