Abstract
Coronary heart disease (CHD) is one of the important disorders in Japan that medical care plans should be designed. The CHD is the most prominent established disorder for which socio-economic inequalities have been observed in the Western countries. Socio-economic status (SES) may become of major concern also in Japan. This article is divided into three sections. The first two sections concern backgrounds on CHD and pathways linking SES with CHD, highlighting psychosocial factors. The latter section describes clues to the prevention of CHD by means of social strategies. Social inequalities can affect CHD risk through some pathways such as health behaviours, access to health care, childhood factors and psychobiological processes, though the risk factors can be confounding each other. Although work to date on psychobiological processes and SES is not conclusive, life course epidemiology and psycho-neuro-immuno-endocrinology are providing the way how social inequalities are translated into differential disease risks. Since physical and social exposures in life have long-term effects on risk of CHD or a lifestyle-related disease, it is hoped that medical care and public health education would thoroughly provided. Public health research based on social epidemiology would be effective also in Japan.
