News item under restrictions until 5:30 p.m. CST March 6.
A research article released on March 6 in The Lancet Regional Health — Americas underscores an increasing gap in cardiovascular health within the U.S., indicating that wealth and education significantly influence the risk of heart disease.
The investigation, spearheaded by Salma Abdalla, MBBS, DrPH, an assistant professor of public health at Washington University in St. Louis, indicates that the wealthiest 20% of college-educated Americans exhibit markedly lower rates of cardiovascular disease compared to the rest of the populace—discrepancies that have expanded over the last 20 years.
Abdalla began this research at Boston University’s School of Public Health prior to her transition to WashU’s recently founded School of Public Health.
Cardiovascular disease (CVD) continues to be the predominant cause of illness and mortality in the U.S., yet this innovative research reveals diverging patterns; the remaining 80% of the populace continues to encounter heightened risks, highlighting the nation’s expanding income inequality.
In spite of the U.S. allocating more funds on healthcare per capita than any other nation with high income, results persist in lagging behind, particularly for individuals with lower incomes and reduced educational backgrounds. Currently, life expectancy for the wealthiest 1% of Americans surpasses that of the poorest 1% by ten years. These outcomes have deteriorated in comparison to other high-income nations.
The research examined two decades of data from nearly 50,000 adults who took part in the National Health and Nutrition Examination Survey from 1999 to 2018. Participants were categorized according to income and educational attainment. The researchers analyzed the occurrence of four major cardiovascular conditions: congestive heart failure, angina, heart attack, and stroke.
Statistical analyses revealed that low-income individuals without a college degree had 6.34 times the likelihood of congestive heart failure, 2.11 times the chance of angina, 2.32 times the risk of heart attack, and 3.17 times the probability of suffering a stroke, in comparison to their more affluent, college-educated counterparts.
Disparities remained significant even after accounting for demographic factors and health indicators such as body mass index, blood pressure, and cholesterol levels. Higher income and educational attainment were consistently associated with improved heart health.
The findings indicate that income and education have a multifaceted role in influencing heart health, necessitating future research to further explore their interplay. The differences noticed in the burden of CVD, even when factoring in certain biological and lifestyle elements, may stem from numerous, overlapping reasons. For instance, a lack of economic stability can lead to chronic physiological stress. Those with higher income and education may have greater overall access to health-promoting behaviors and activities throughout their lifetimes. Furthermore, they are likely to obtain more comprehensive healthcare, characterized by better continuity and timely interventions. They may also showcase improved adherence to medication, encounter lesser exposure to environmental toxins, and benefit from more robust support systems.
“The accumulation of economic and educational advantages seems to drive healthier outcomes, rather than any singular element alone,” Abdalla stated. “Wealth and education tend to cluster within a small, privileged group, while the bulk of Americans confront an elevated risk of heart disease.”
Tackling CVD, she noted, requires more than merely expanding access to healthcare; it necessitates strategies that encourage widespread, long-term economic opportunities and educational equity while dismantling structural hurdles.
The senior author of the study, Sandro Galea, MD, DrPh, the Margaret C. Ryan Dean of the School of Public Health and the Eugene S. and Constance Kahn Distinguished Professor in Public Health at WashU, stressed the implications of these findings for policy.
“The ongoing escalation of health disparities in the U.S. highlights the urgency for action,” Galea remarked. “To enhance public health outcomes, we must confront the underlying causes—economic opportunity, education, and access to resources that bolster long-term health.”
This research received funding from The Rockefeller Foundation and included collaborations with the School of Social and Political Science at the University of Edinburgh and the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital.
The article Study reveals widening heart disease disparities in the US first appeared on The Source.