By: on In Living Healthy

Low-Income Communities and the Increased Risk of Heart Attacks

Low-income and poverty-stricken communities have traditionally been known to face numerous challenges. Modern medical researchers are increasingly coming to the opinion that based on existing evidence, there’s a direct correlation between lower socioeconomic status and various forms of heart disease.

Factors like limited access to education, resources and food make many aspects of life harder for individuals from low-income groups. While such issues have the potential to impact heart attack rates, lower income and social status alone may be sufficient to cause a higher incidence of significant health problems.

Who’s in Danger of Heart Attacks?

Heart attacks often seem to strike sufferers with little warning. Nonetheless, there are numerous established factors that have been shown to contribute to people’s chances of contracting these heart diseases.
Heart Attack Basics

The National Institutes of Health, or NIH, defines heart attacks as being characterized by a cutoff in the flow of oxygenated blood to part of the heart muscle.[1] Without immediate restoration of the oxygen supply, the affected tissue will perish.

In the vast majority of cases, heart attacks occur in individuals who suffer from CHD, or coronary heart disease. This ailment commonly includes the buildup of waxy plaque inside the large coronary arteries that supply the heart with blood. Plaque could accumulate for some time before a section breaks off and causes a clot to form that significantly restricts blood flow to the heart.

If left untreated, heart attack and CHD conditions may result in the growth of scar tissue and heart failure, or an inability to supply the body with sufficient blood. Some individuals contract arrhythmia, or persistent heart rate problems. These issues can commonly be fatal.

Heart Attack Risk Factors

Behaviors that contribute to CHD vulnerability include smoking, having excessively high blood pressure and having high cholesterol. Those with diabetes or high blood sugar caused by insulin resistance are also at risk. So are people who don’t regularly exercise or who consume diets heavy in saturated fats, cholesterols, sodium and trans fats. In addition, being overweight or obese heightens a patient’s chances of experiencing an attack at some point in their lifetime.

Those with metabolic syndrome, or combined risk factors, are twice as likely to develop heart problems. Hazards become more prevalent after men reach the age of 45 and following the age of 55 or the occurrence of menopause in women. Some evidence suggests that hereditary factors also play a role. For instance, people may be at more risk if their fathers or brothers contracted heart disease before reaching 55 or their mothers or sisters were diagnosed prior to age 65. In some cases, preeclampsia, or high blood pressure and urine-protein content in pregnant women, is correlated with subsequent heart disease in later life.[2]

How Does Low Socioeconomic Status Relate to CHD Risks?

Definitions of poverty vary by region, nation and even within similar social associations, such as ethnic groups and age ranges. Nonetheless, a relatively broad spectrum of multinational studies seem to indicate that low income leads to more problems across the board.

A Global Problem

Researchers say that in modern times, CHD is the largest cause of fatality in developing countries.[3] It also represents one of the most prevalent disease burdens in these areas. For example, 75 percent of the worldwide CHD deaths in 2001 took place in low-income or middle-income nations.

Studies have also been conducted in relatively-wealthy nations, like the United States. These examinations reveal that even in countries with improved standards of living, those who lack income typically fall prey to heart disease more often.

One 2011 Emory University assay looked into cardiovascular disease, or CVD, risks. It found that the chances of risks such as being obese or inactive were about 50 percent higher for economically-challenged youths between the ages of six and 17.[4] These groups were also two times as likely to be exposed to toxins like tobacco at potentially damaging levels.

Many of these examples focus on CVD in general. It’s important to remember, however, that CHD and related health issues are believed to be underlying causes of most heart attacks. Living conditions that expose people to risk factors on a regular basis may ultimately place them in more danger.

Do Economic Challenges Themselves Pose Heart Health Risks?

Many heart-health regimens and treatment efforts focus on managing patient exposure to risk factors. For instance, patients who suffer attacks, high blood pressure and other CVD issues are commonly advised to begin smoking cessation, modify their diets, engage in exercise or enact other lifestyle changes. Unfortunately, some research indicates that the risks associated with low socioeconomic status may ultimately be harder to overcome.
Tracking Changing Risks Over Time

An interesting UC Davis study published in 2011 gathered information on no less than 12,000 individuals between the ages of 45 and 64 who resided in Minnesota, Mississippi, North Carolina and Maryland.[5] Over the course of ten years beginning in 1987, the subjects were routinely assessed for their CVD risk factors, actual heart disease diagnoses, income levels and educations.

Unsurprisingly, the UC Davis results showed a 50 percent higher CVD risk for those with less income. A more unexpected discovery was that even after long-term risk management and improvement, lower-income individuals remained in more danger. The researchers believe the effects of being economically challenged for many years could explain this by exerting more stress on the circulatory system.

Some even suggest that being disadvantaged might cause children to develop certain stress adaptations that take a toll later on. The U.S. Office on Women’s Health notes that the children of economically-challenged families commonly exhibit higher incidences of heart disease when they grow up.[6]

Researchers who agree with these findings say that socioeconomic status ought to be counted as an independent risk factor. Nations like the United Kingdom employ income assessments when determining acceptable treatment regimens, and it may be time for the rest of the world to follow suit.

The Dangers of Insufficient Care

One of the biggest issues for people in lower-income situations is lack of access to healthy resources. The World Health Organization maintains that noncommunicable ailments, like CVD, are more prevalent in low-income nations because their citizens can’t obtain appropriate healthcare services quite as easily.[7] As a result, the problems these individuals suffer from may not be detected until it’s too late to begin effective treatment.

Another noteworthy factor is that residents of developing nations often lack access to primary healthcare programs. Among these nations, such effects are most obvious in the poorest households, which tend to spend more on emergency health costs and out-of-pocket care expenses.

Lacking adequate protection, such as insurance, and robust public safety nets could easily contribute to increasing debts for those who suffer from heart attacks. This, in turn, could make future repeat events harder to manage.

Food Availability and Nutrition

Food economics and distribution may also play a role in low-income CVD risks. For instance, the Food Research & Action Center identifies a number of issues that make low-income individuals in America more vulnerable to obesity, which can contribute to heart disease.[8]

Many residents of poorer neighborhoods have to travel out of their neighborhoods to access full-service grocery stores, a phenomenon known as living in a food desert.[9] At the same time, these neighborhoods are commonly packed with nutrient-low, calorie-high fast food restaurants.

Fewer poor individuals are likely to own their own vehicles for tasks like grocery shopping. Many also face the realities that healthy foods are often sold at premium prices and that produce and other normally-healthy fare is only locally available in low-quality forms.

Being constrained by a budget prompts some people to stretch their financial resources by purchasing whatever is cheapest. This typically results in people obtaining larger quantities of unhealthy foods that may be tied to obesity rates.

Behavior and Advertising

Children are in particular danger. Schools and communities in low-income areas are less likely to promote recess, physical activity or organized sports. In addition, local dangers such as crime, urban traffic and poorly-maintained public resources can make the mere act of physical play less safe, which might discourage the practice. Evidence also suggests that people of all ages in impoverished communities receive greater exposure to marketing and advertising for products that contribute to being overweight or unhealthy.
Dealing With the Risks

The social ills of poverty and income disparity are unlikely to be resolved in the near future. Instead, medical practitioners and researchers will have to account for such factors as they study and attempt to treat heart attacks, CVD and other related diseases.

Socioeconomically-challenged individuals aren’t only in increased danger of heart problems. Many also face disparate rates of stroke, diabetes and other diseases.[10] While managing risk factors is an important part of limiting negative outcomes, caregivers and social advocates can’t do everything alone.

Families, individuals and communities also have to take steps to mitigate hazards. For such initiatives to work properly, it’s critical that parents and other individuals receive more potent educations about how their decisions might affect themselves and their children for decades to come.

Sources:
[1] What Is a Heart Attack? (n.d.). Retrieved May 27, 2016, from http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/
[2] Preeclampsia: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved May 27, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/000898.htm
[3] Gaziano, T. A.

, Bitton, A., Anand, S., Abrahams-Gessel, S., & Murphy, A. (2010). Growing Epidemic of Coronary Heart Disease in Low- and Middle-Income Countries. Current Problems in Cardiology, 35(2), 72-115. doi:10.1016/j.cpcardiol.2009.10.002. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20109979
[4] Youth from Low Income Families Have Higher Prevalence of Heart Disease Risk Factors. (n.d.). Retrieved May 27, 2016, from http://shared.web.emory.edu/whsc/news/releases/2011/08/youth-from-low-income-families-have-higher-prevalence-of-heart-disease-risk-factors.html
[5] Lower socioeconomic status linked with heart disease despite improvements in other risk factors. (2011, August 26). Retrieved May 27, 2016, from http://www.ucdmc.ucdavis.edu/publish/news/newsroom/5660
[6] Heart Health and Stroke. (2009, February 1). Retrieved May 27, 2016, from http://womenshealth.gov/heart-health-stroke/heart-disease-risk-factors/other-heart-disease-risk-factors.html#income
[7] Cardiovascular diseases (CVDs). (2015, January). Retrieved May 27, 2016, from http://www.who.int/mediacentre/factsheets/fs317/en/
[8] Why Low-Income and Food Insecure People are Vulnerable to Obesity « Food Research & Action Center. (n.d.). Retrieved May 27, 2016, from http://frac.org/initiatives/hunger-and-obesity/why-are-low-income-and-food-insecure-people-vulnerable-to-obesity/
[9] A Look Inside Food Deserts. (2012, September 24). Retrieved May 27, 2016, from http://www.cdc.gov/features/FoodDeserts/index.html
[10] Risks for Heart Disease & Stroke. (n.d.). Retrieved May 27, 2016, from http://millionhearts.hhs.gov/learn-prevent/risks.html