Economic issues drive disparities in heart disease, stroke

May 4, 2018, American Heart Association News Stories
Economic issues drive disparities in heart disease, stroke
Credit: American Heart Association News Stories

State-by-state disparities in heart disease and stroke are rooted in the economic health of communities and the people who live in them, according to an analysis of a report tracking the impact of cardiovascular disease across the country.

Despite a 38 percent overall drop in cardiovascular in the U.S. from 1990-2016, some states improved more slowly than others and a dozen states fell behind.

"Socioeconomic factors play a role. People with very low income who may struggle to put food on the table or keep a roof over their head can find it difficult to prioritize exercise, eating healthy, or even get to the doctor," said Dr. Gregory Roth, a cardiologist and the report's lead author.

"It's not just a health problem," Roth said, "but an economic problem and an economic policy problem in terms of giving people the resources they need so that when they get sick they're not going to die from their illness."

Lower-income communities are less likely to attract or investment in a health care facility, he said. Health care access can be limited by addictions, , or a lack of transportation resulting from unemployment.

Published last month in JAMA Cardiology, the report tracked deaths from cardiovascular diseases including heart attack, stroke, irregular heart rhythms and . It also looked at a dozen ; the number of people living with cardiovascular disease; and income and education levels. Researchers analyzed the overall burden of these diseases for each state and ranked them.

The effort is part of the University of Washington School of Medicine's broader "Global Burden of Disease Study" created by the Institute for Health Metrics and Evaluation in Seattle, where Roth leads cardiovascular disease modeling. The larger study investigated 332 causes of diseases and injuries, and 84 risk factors in 195 countries and territories.

Poor diet was the leading risk factor impacting cardiovascular health in the report, making it a "critical target" for improvement, according to an editor's note by Mark Huffman, associate editor of JAMA Cardiology and associate professor of prevention at Northwestern University Feinberg School of Medicine in Chicago.

Other top risk factors included high blood pressure; high body mass index; high cholesterol; and high blood glucose levels, an indicator of diabetes.

Researchers and doctors have spent years studying the causes of and what factors promote cardiovascular health, and an important part of that is the social and economic environment in which people work and live, said Wayne Rosamond, professor of epidemiology at the University of North Carolina's Gillings School of Global Public Health.

To successfully fight heart disease, Rosamond said, states need to work to evaluate their communities, then support and promote environmental, social and economic conditions that favor .

Roth said health departments and hospitals should know and benchmark their progress. "If you can't measure it, you'll never know if health is getting better or worse."

One of the solutions is to start early, with children, Roth said.

"We need to improve children's skills and capacity to live healthy lives," he said. This involves avoiding tobacco and alcohol, building coping mechanisms for depression, or solving education challenges so children don't end up having a lifelong health problem.

For example, the rise of vaping in schools is troubling and could threaten national gains in smoking reduction, Roth said. "When we see a new technology that's addicting children to nicotine, we need to be very, very worried."

High-quality, affordable health care also should be part of the solution, according to researchers.

Cardiovascular disease will continue to be a problem "as long as we believe that health is only something you should have if you can afford to pay for ," Roth said.

Mississippi had the highest impacts from cardiovascular disease in 1990 and again in 2016. But it improved significantly, lowering its burden by nearly a third, Roth said. Its rank didn't change because other states also improved, largely because of improved treatments and healthier behaviors.

After Mississippi, the highest burden was in Arkansas, Oklahoma, Louisiana, Alabama, Tennessee, Kentucky, West Virginia, South Carolina and Georgia. Other states ranked nearly as high: Indiana, Missouri, Ohio, Michigan, North Carolina, Nevada and Texas.

The healthiest state was Minnesota, followed by Colorado, Massachusetts, New Hampshire, Washington, Connecticut, Vermont and Oregon.

Cardiovascular disease is the leading killer of men and women in the U.S., according to the American Heart Association. It can be prevented by treating risk factors such as , high cholesterol, tobacco use, unhealthy diet, obesity and low levels of physical activity, according to the researchers.

But not enough has been done, Roth said, "to address the root causes of disparity between states, even as we have done a lot to treat [cardiovascular] disease itself."

Explore further: U.S. heart disease rates falling, but gains vary by state

More information: undefined undefined et al. The Burden of Cardiovascular Diseases Among US States, 1990-2016, JAMA Cardiology (2018). DOI: 10.1001/jamacardio.2018.0385

Related Stories

U.S. heart disease rates falling, but gains vary by state

April 11, 2018
(HealthDay)—The overall rate of heart disease in the United States has declined 38 percent since 1990, a new report shows.

Cardiovascular disease causes one-third of deaths worldwide

May 17, 2017
Cardiovascular diseases (CVD), including heart diseases and stroke, account for one-third of deaths throughout the world, according to a new scientific study that examined every country over the past 25 years.

Global burden of cardiovascular disease assessed

May 18, 2017
(HealthDay)—Cardiovascular disease (CVD) is a major global burden, despite declines in the mortality rate due to CVD in high-income and some middle-income countries, according to a study published online May 17 in the Journal ...

Better health care as important as controlling risk factors for heart health

August 27, 2014
Keeping a healthy heart may have as much to do with the quality of health care you have available as it does you avoiding risk factors such as smoking, bad diet and little exercise.

New statistics show one of every three US deaths caused by cardiovascular disease

December 16, 2015
One of every three deaths in the U.S. in 2013 were from heart disease, stroke and other cardiovascular diseases, while heart disease and stroke were the No. 1 and No. 2 killers worldwide, according to American Heart Association's ...

For older adults, keeping your heart healthy may protect against disability

October 26, 2017
A healthy heart is important to the well-being of older adults. The American Heart Association (AHA) defines "ideal cardiovascular health" based on four health behaviors (current smoking, body mass index, physical activity, ...

Recommended for you

Natural antioxidant bilirubin may improve cardiovascular health

May 18, 2018
Bilirubin, a yellow-orange pigment, is formed after the breakdown of red blood cells and is eliminated by the liver. It's not only a sign of a bruise, it may provide cardiovascular benefits, according to a large-scale epidemiology ...

New algorithm more accurately predicts life expectancy after heart failure

May 17, 2018
A new algorithm developed by UCLA researchers more accurately predicts which people will survive heart failure, and for how long, whether or not they receive a heart transplant. The algorithm would allow doctors to make more ...

New genes found that determine how the heart responds to exercise

May 17, 2018
A new study by researchers at Queen Mary University of London and University College London (UCL) has discovered 30 new gene locations that determine how the heart responds to and recovers from exercise.

Novel therapy inhibits complement to preserve neurons and reduce inflammation after stroke

May 16, 2018
A team of investigators at the Medical University of South Carolina (MUSC) has developed a novel therapy for ischemic (clot-caused) stroke and has shown in a preclinical model that it locally inhibits complement at and around ...

Greater burden of atrial fibrillation linked to higher stroke risk

May 16, 2018
Among people with intermittently recurring atrial fibrillation who are not taking anti-blood-clotting medications, those whose hearts were in abnormal rhythms longer were three times more likely to have strokes or other types ...

Stroke prevention drug combo shows promise, study says

May 16, 2018
If you've had a minor stroke or a transient ischemic stroke (TIA), taking the clot-preventing drug clopidogrel along with aspirin may lower your risk of having a major stroke within the next 90 days, according to new research ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.