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Paediatr Child Health. 2018 Apr;23(2):92-95. doi: 10.1093/pch/pxx146. Epub 2017 Nov 2.

Early life environment and social determinants of cardiac health in children with congenital heart disease.

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Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario.


Congenital heart disease is a significant cause of infant mortality. Epidemiology and social context play a crucial role in conditioning disease burden and modulating outcomes, while diagnosis and treatment remain resource intensive. This review will address the role of social demographics, environmental exposure, epigenetics and nutrition in the aetiology of congenital heart disease. We then discuss the determinant effect of social factors on the provision and outcomes of care for congenital heart disease and implications for practice. It is our hope that enhanced knowledge of the intersection of social determinants of health and congenital heart disease will facilitate effective preventative strategies at the individual and population levels to optimize heart health outcomes across the life course.


Child; Heart diseases; Life course; Risk factors; Social environment; Socioeconomic factors

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