September 13, 2023 — Socioeconomic status (education, income, employment status and health insurance) appears to be an uneven predictor of heart health with white adults benefitting the most in comparison to Black, Hispanic and Asian Americans, according to a study led by researchers at The Ohio State University Wexner Medical Center and College of Medicine.
The study suggests heart disease prevention efforts should not rely solely on reducing socioeconomic disparities by race and ethnic groups but should also address other social determinants of health that drive cardiovascular health inequities, said senior author Joshua Joseph, MD, an associate professor of internal medicine. Those factors include psychosocial stress experienced by people in different groups due to medical mistrust and unequal access to care and wealth, according to the study published today in the Journal of the American Heart Association.
“We thought there may be differences among minoritized and non-minoritized groups, but we did not expect that the range of cardiovascular health scores with lower and higher levels of socioeconomic status would be greatest among white Americans,” said Amaris Williams, PhD, a research scientist in the Division of Endocrinology, Diabetes and Metabolism.
Cardiovascular disease is the leading cause of death in the United States with significant disparities in mortality existing based on social constructs of race and ethnicity. The study assessed the measures of socioeconomic status with the American Heart Association’s Life’s Essential 8 metrics of heart health across racial and ethnic groups in the United States using diverse, nationally representative survey data from about 13,500 adults.
The analysis found that across all participants, higher socioeconomic status was linked with better heart health, as indicated by higher average Life’s Essential 8 scores, a 0-100 scale. However, this link was greatest among white adults compared to people in other racial/ethnic groups. For example:
- College education was associated with a 15-point increase in Life’s Essential 8 heart health score among white adults, compared to about a 10-point increase for Black and Hispanic adults and about an 8-point increase among Asian American adults.
- Medicaid versus private health insurance was associated with a 13-point decline in Life Essential’s 8 heart health scores among white adults, compared to a 5- to 6-point decline for people in other racial and ethnic groups.
The next step in the research is to evaluate populations with socioeconomic status and cardiovascular health measured over many years to understand how changes in socioeconomic status over time drive changes in cardiovascular health as measured by Life’s Essential 8, Joseph said.
“We also would like to understand what some of the factors are that are driving differential attainment of Life’s Essential 8 at higher and lower levels of socioeconomic status since these factors will be critical to address through interventions,” he said.
For more information: https://wexnermedical.osu.edu/