A recent study published in The Lancet Regional Health—Americas sheds light on the growing disparity in cardiovascular health in the United States, revealing that wealth and education are significant factors in determining heart disease risk.
The research, led by Salma Abdalla, MBBS, DrPH, an assistant professor of public health at Washington University in St. Louis, highlights the widening gap in cardiovascular disease rates between the top 20% of high-income, college-educated Americans and the rest of the population. This disparity has become more pronounced over the past two decades.
Despite cardiovascular disease remaining the leading cause of illness and death in the U.S., the study shows that the remaining 80% of the population faces higher risks, reflecting the nation’s increasing income inequality. This trend is concerning, especially since the U.S. spends more on healthcare per capita than any other high-income country, yet outcomes continue to lag behind, particularly for those with lower incomes and less education.
The study analyzed data from nearly 50,000 adults who participated in the National Health and Nutrition Examination Survey between 1999 and 2018. Participants were categorized based on income and education levels, and researchers examined the prevalence of four major cardiovascular conditions: congestive heart failure, angina, heart attack, and stroke.
The results of the study showed that low-income individuals without a college degree were significantly more likely to experience cardiovascular diseases compared to their wealthier, college-educated counterparts. Even after adjusting for demographics and health markers like body mass index, blood pressure, and cholesterol levels, the disparities persisted, underscoring the impact of income and education on heart health.
The findings suggest that income and education play a complex role in shaping heart health, with future studies needed to explore their interaction further. Factors such as economic security, access to health-promoting behaviors, quality of medical care, medication adherence, environmental exposures, and social support systems all contribute to the disparities observed in cardiovascular disease burden.
Addressing cardiovascular disease requires more than just expanding access to healthcare; it also necessitates policies that promote economic opportunity and educational equity to break down structural barriers that perpetuate health inequities. The study’s senior author, Sandro Galea, emphasized the importance of addressing the root causes of health disparities in the U.S. by focusing on economic opportunity, education, and access to resources that support long-term health.
In conclusion, the study highlights the urgent need for action to address the widening gap in cardiovascular health in the United States. By focusing on addressing socioeconomic disparities and promoting health equity, policymakers and healthcare providers can work towards improving public health outcomes and reducing the burden of cardiovascular disease across all segments of the population.
