WASHINGTON (April 3, 2024) – Over the past three decades, deaths from heart disease have plummeted in the United States, but new research suggests the benefits for cardiovascular disease apply only to people in high-income brackets. For poor people, the incidence of heart attacks remained the same or worsened over the course of 30 years.

“The decline in cardiovascular health has not been shared equally over the past 30 years,” said Adam Richards, associate professor of global health medicine at George Washington University. “This study shows that we need to think long and hard about how to improve access to health care and other social determinants of health that contribute to elevated cardiovascular risk in low-income households. It shows.”

Richards and his colleagues evaluated data from a national survey of about 27,000 people between the ages of 40 and 75 who had never had a heart attack or stroke. They calculated the estimated 10-year risk of cardiovascular disease for each six-year study period. Country-level trends, which do not take income into account, show improvements in cardiovascular disease from 1988 to 2018.

However, when researchers examined the distribution of these changes according to household income, they found that many of the heart health benefits are not experienced equally among members of society. Although his 10-year cardiovascular risk decreased from 7.7% to 5.1%, Cardiovascular risk among the lowest-income groups remained stagnant at more than 8%, compared with 7.6% for the richest group of the population and 7.6% to 6.1% for the second-richest group.

Although this study was not designed to explore the underlying reasons behind the inequalities, other studies have shown that improvements in treatments and risk factor management each contributed to It explains about half of the reduction in vascular mortality, indicating that this difference is likely occurring. Trends in treatment access and risk factors are contributing to growing income-related inequalities.

The United States is the only high-income country without universal health care, and even poor people with insurance face financial, transportation, and other barriers to accessing health care. Richards said income and other measures of socioeconomic status and power fundamentally shape the landscape of opportunity to live long, healthy lives in the United States. Smoking, obesity, and diabetes are increasingly concentrated in low-income groups, and compared to other high-income countries, the U.S. has the ability to promote social determinants of health, such as paid child care, medical leave, family leave, and food. There is little investment in a wide range of policies. and nutritional benefits, he said, that can help counteract the unhealthy effects of poverty.

According to the American Heart Association, heart attacks and strokes have been the leading cause of death in the United States for 100 years.

the study, Trends in income inequality in cardiovascular health among U.S. adults, 1988-2018published in the journal April 3, 2024 Circulation: Cardiovascular quality and outcomes.

-GW-