Commentary: Understanding the pathophysiology of poverty

Simanek et al.’s article in this issue of the Journal1 brings together two fields of research, both of which have a long history and have recently enjoyed a resur-gence of interest. The first is the infectious hypothesis of atherosclerosis and the second is the social deter-minants model for cardiovascular disease (CVD). The hypothesis that infections might be involved as aetiologic factors in CVD dates back to the late 1800s, though it all but disappeared for most of the 20th century. Interest in his hypothesis, however, surged again during the last two decades of the century, when both experimental and epidemiologic evidence documented its plausibility.2–4 Similarly, even though discussion of the social determinants of health dates back to the very origins of public health,5 newcomer