Social factors contributing towards heart disease : development of a social support model for heart patients

Abstract

Social factors, which themselves are also significantly influenced by culture, have been found to play a significant role in the etiology, progression and prognosis of heart disease. The present study therefore chose to focus on Black South African heart patients, a demographic group that has not been as widely studies as others and in which the role played by social factors and cultural in the incidence of heart disease is less understood (Micklesfield, 2013; Fischler, 2011). Furthermore, while the etiology, progression, and management of this condition are particularly affected by social factors, most researchers have, however, tended to focus more on the bio-medical aspects of the disease, which has created a gap in terms of effective social support programmes for heart patients. In view of the foregoing, the main aim of the study was to use literature sources in conjunction with an exploratory qualitative study to identify the social factors relevant to heart disease, and to integrate these findings into a proposed social support model for Black South African heart patients. Majority of theories in relation to heart disease were crafted from a context of abundance especially in the West where the major issue was underpinned by the need for individual self-denial and restriction on some foods at their disposal. The poverty perspective therefore comes in as a new aspect that needs more research because it is also compounded with other factors that have been identified from a materialistic setting, e.g., stress. This in a way validates Fischler’s (2011) notion of ‘nutritional cacophony’, where he argues that people who eat (have plenty) die and yet people who do not eat (poor) die too, but usually quite a bit faster. This further validates the significance of this study as it highlights a new dimension of how poverty and lack are key factors contributing to heart disease in resource poor Black African settings. Firstly, the researcher conducted a review of literature to investigate the social factors contributing to heart disease with the aim of developing a social support model for Black South African heart patients. Findings revealed that Black South African heart patients who receive constant social support from peers, family members and community members show good progress with regard to their state of health Compared to the health of heart patients who do not receive social support, which tends to deteriorate. Secondly, an exploratory qualitative study was conducted in which data was collected by means of semi-structured interviews (i.e. qualitative approach) with Black South African heart disease patients (10 males and 9 females, ages 18 – 64 years) and professional health care practitioners (4 medical doctors, 6 nurses, 5 social workers and 4 care givers) from public hospitals in Tshwane. The findings also revealed that heart patients’ quality of life is impacted by social factors such as stress, poor diet, lack of exercise, tobacco smoking, alcohol abuse and poverty. Health professionals concurred with these findings, further pointing to the fact that most Black South African heart patients as well as their families lived in poverty, which served as root source of many other compounding social factors. Thirdly, the themes derived from the qualitative study as well as the literature review were subsequently collated and analysed with the use of ATLAS Ti 6.0 with the aim of developing a social support model for Black South African heart disease patients. The model outlines the various parties and institutions that are able to mediate the social factors related to heart disease and proposes possible ways in which they might supportively interact with each other in order to promote the well-being of Black South African heart patients. In particular, it suggests a number of ways that some government structures like the local government and the provincial government can be actively involved in providing medication and entrepreneurial support for those who cannot afford medication or healthy diets, and also outlines possible avenues through which the necessary education might be given to Black South African heart patients and the family members who live with them.