What are the most effective public health strategies for promoting mental health and reducing the cardiovascular burden associated with depression?

Abstract

ABSTRACT

Background Depression is a significant contributor to the global disease burden and is strongly associated with increased cardiovascular mortality and morbidity. Mental health disorders, particularly Depression, influence biological processes such as health behaviours and inflammation. Autonomic dysfunction results in adverse cardiovascular outcomes. Public health strategies focused on addressing mental health could concurrently reduce the burden of cardiovascular diseases. However, identifying the most effective strategy requires a systematic and critical review approach.

Methods A critical literature review employs the PICOS (Population, Intervention, Comparator, Outcome, Study design) framework. Databases such as Medline, Scopus, PsycInfo, and Web of Science were searched using keywords and medical subject headings related to depression, cardiovascular disease, mental health promotion, and public health strategies. Inclusion criteria comprised peer-reviewed articles published between 2010 and 2024, concentrating on adult populations and studies reporting cardiovascular and mental health outcomes and interventions at the population or community level. Exclusion criteria eliminated studies focusing solely on pharmacological interventions or those lacking a cardiovascular component.

Results The review found seven studies that met the inclusion criteria. Major interventions included psychological therapies based on community, lifestyle modification initiatives, workplace Programs for mental wellness, physical activities, and policy-driven campaigns that address social determinants of health. Multifaceted interventions incorporating psychological support with managing cardiovascular risk depicted the most significant improvement in mental wellbeing and reduction of cardiovascular markers such as BMI, blood pressure, and inflammation. School and workplace-based programs depicted positive long-term change in behaviour, specifically when culturally adapted. However, disparities in accessibility, sustainability, and responsiveness towards give remain challenges across many low- and middle-income countries.

Conclusion Practical strategies for public health that promote mental health and reduce the multi-tiered cardiovascular burden should target individual and structural interventions. Programs that combine mental health promotion with cardiovascular health education and behavioural change interventions, especially those driven by community and context-specific factors, tend to yield the most impactful results. Future research should address gaps in culturally inclusive models with sustainable delivery systems.