Dear Dr Raphael,

In a recent letter to the list you suggest that broad economic and social
conditions are major determinants of cardiovascular disease. For example,
you mention that social exclusion is the means by which low income causes
cardiovascular disease. Do you mean that broad economic and social
conditions are simply surrogates - at a population level - for
already-recognised 'biomedical' risk factors for cardiovascular disease,
e.g. smoking? Has anyone estimated how much of the 'risk' in low income /
social exclusion can be put down to smoking, diet, etc - the 'known'
biomedical risk factors for cardiovascular disease?

Nick Simpson, MPH student
UNSW, Australia

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