Research also reveals potential widening disparities in the US – ScienceDaily
According to a new study published recently in Mayo Clinic ProceedingsThe study, by researchers at University Hospitals (UH) Harrington Heart & Vascular Institute, found that social deprivation may explain a significant proportion of geographic variation in premature cardiovascular mortality in the United States.
Socioeconomic deprivation is defined by a number of social and economic factors, including education, income, employment, and neighborhood environment. There is a large gap in the explanation of premature CV deaths in the United States that cannot be fully attributed to traditional risk factors such as high cholesterol. Recent evidence suggests that socioeconomic deprivation is a risk factor for this type of mortality.
“Socioeconomic status plays an important role in access to preventive care, control of risk factors, and disease incidence,” said Sadeer Al-Kindi, MD, cardiologist and co-director of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA) with UH Harrington Heart & Vascular Institute and lead study author. “UH is committed to improving the health of all by advancing science and human health. A big part of that is uncovering the root cause of disease. With this study, we wanted to determine if premature cardiovascular mortality is associated to socioeconomic deprivation and how premature cardiovascular mortality changed over time by social deprivation.”
In “Socioeconomic Deprivation and Premature Cardiovascular Mortality in the United States,” researchers conducted a cross-sectional analysis of U.S. county-level death certificate data from 1999 through 2018 using files maintained by the National Center for Health and Statistics of the United States. They examined people between the ages of 25 and 64 who had died of cardiovascular disease. They used linear regression analysis to document two integrated measures of socioeconomic deprivation: the Social Deprivation Index (SDI) and the County Area Deprivation Index (ADI).
The results of this research showed that counties with high social deprivation had the highest rates of premature cardiovascular death. Additionally, from 1999 to 2018, premature cardiovascular mortality decreased to a lesser extent in socially disadvantaged counties compared to wealthy counties. In fact, indicators of social deprivation directly explained a significant proportion of geographic differences in premature CV mortality in the United States.
“Health and structural inequalities in poor communities have been ignored for too long. We now know that where you live, inequalities and other things embedded in the environment are powerful determinants of mortality, often due to chronic non-communicable diseases. More importantly, shedding light on this pervasive problem requires us to act on the information,” said Sanjay Rajagopalan, MD, chief of cardiovascular medicine and academic and scientific director of UH Harrington Heart & Vascular Institute and co-author of the study, as well as the Herman K Hellerstein, MD, Chair in Cardiovascular Research.
UH takes action in many ways, including through its work in the community through the ACHIEVE Greater initiative. A ‘transformative’ $18.2 million federal grant from the National Institutes of Health’s P50 program will facilitate medical and cardiovascular care provided directly to people living in the Cuyahoga Metropolitan Housing Authority, one of the largest subsidized housing programs and the oldest in the country. Additional efforts by the study team are focused on understanding the integrated social and environmental underpinnings of premature cardiovascular disease in northeast Ohio and nationally.
“No matter where they live or how much money they make, everyone should have the opportunity to receive the medical resources and support needed to lead healthier lives,” said Dr. Mehdi Shishehbor, DO, MPH, PhD. , president of UH Harrington. Heart & Vascular Institute and the Angela and James Hambrick Chair in Innovation.
Previous studies have explored the relationship between race and premature CV mortality or individual socioeconomic factors (income, high school education) and CV mortality.
“To our knowledge, this is the first study to demonstrate a longitudinal association between multiple integrated measures of socioeconomic deprivation and premature cardiovascular mortality adjusted for traditional cardiovascular risk factors, while also showing potentially compounded disparities. said Dr. Al-Kindi.