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Jan 22, 2018

Living in a Poor Neighborhood Increases Heart Failure Risk

Where we live could have a direct impact on our heart function, study finds. 

Where you live could have a direct impact on heart health, based on a recent study that found U.S. adults living in disadvantaged areas face increased risk for heart failure.

Published in Circulation: Cardiovascular Quality and Outcomes, this study looked at the impact of one’s neighborhood on risk for heart failure. It’s well established that individual factors like income, education and race can have an effect on health outcomes. However, whether neighborhood environment has its own impact on heart health is less clear.

To learn more, researchers analyzed data from the Southern Community Cohort Study, which explores health disparities related to cancer, heart disease and other serious conditions. The study included 27,078 middle-age low-income adults, who were all free of heart failure at the start of the study.

Heart failure occurs when the heart doesn’t pump blood as well as it should and is a major public health issue, especially in the southeastern United States.

Participants enrolled between 2002 and 2009 and were followed for roughly five years, tracking key outcomes like heart failure and death.

Overall, nearly two-thirds of participants were female, black and low-income. More than half lived in the most deprived neighborhoods, as defined by a national index. This index rates neighborhoods on a scale of 1–3 and takes into account factors like housing, income, education and employment rates in the area. The higher the score, the more disadvantaged the neighborhood.

After following participants for roughly five years, 16% of participants had developed heart failure. Researchers found that each increase in the neighborhood deprivation index was associated with a 12% increase in risk of heart failure. In other words, participants in the second tier had 12% greater risk of developing heart failure than those in the first. Those in the third tier, which includes the poorest neighborhoods, had 24% greater risk of developing heart failure than those in the first tier of neighborhoods.

These associations existed after taking into account individual factors like race, income and weight.

Findings highlight the importance of addressing community resources, in addition to individual health, to combat health disparities. If a patient takes steps to improve their health but still lives in a poor, disadvantaged neighborhood, they still may face increased health risks based on their neighborhood environment. At the same time, improving socioeconomic factors in a community alone will not address the individual components that also have a direct impact on health.

Therefore, policies must target the entire spectrum of factors that influence public health in order to overcome health disparities, particularly in the poorest areas of the country.

Questions for You to Consider

  • What are health disparities?
  • Health disparities refer to differences in health outcomes or burdens of disease between groups of people. Health disparities can exist between different populations of race, sex, income, or even geographic location. In health care, the goal is to eliminate these differences so all individuals have the same ability to achieve good health.
  • What is heart failure?

  • Heart failure occurs when the heart is unable to pump enough blood to the rest of the body. Although there is no cure for heart failure, treatments such as ACE inhibitors and ARBs can help improve outcomes as well as quality of life.

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