Life in Poor Neighborhoods Is Hard on the Heart

Where you live could influence how likely you are to develop heart failure, a new U.S. study suggests.

In addition to people’s income and education level, the neighborhood in which they lived helped predict their risk, according to the researchers. People living in the poorest areas were at highest risk for heart failure, the researchers found.

The availability of gyms, places to buy healthy foods and medical facilities accounted for nearly 5 percent of the increased heart failure risk in low-income areas, the study suggested. The researchers noted that improving access to these resources could benefit people living in these neighborhoods.

“There is existing evidence suggesting strong, independent associations between personal socioeconomic status — like education, income level and occupation — and risks of heart failure and many other chronic diseases,” said study author Loren Lipworth. She’s an associate professor of epidemiology at Vanderbilt University Medical Center in Nashville.

“What this study adds is evidence suggesting that characteristics of your place of residence actually also play a significant role in influencing the risk of heart failure over and above the role of your own individual socioeconomic characteristics,” she said in a news release from the American Heart Association. “It opens the door for possible interventions that center on preventive measures in the community.”

The researchers used Census data on just over 27,000 middle-aged residents, to compare neighborhood socioeconomic variables in 12 southeastern states. The data included residents’ wealth, education, jobs and housing patterns.

Most of the participants were underinsured and lived in areas with limited resources. More than half lived in the most deprived neighborhoods, and 75 percent earned less than $15,000 a year. Nearly 39 percent did not have a high school diploma, and 44 percent were obese.

During an average follow-up period of more than five years, 4,300 people were diagnosed with heart failure.

Those living in low-income areas were at highest risk for heart failure. The researchers noted that as socioeconomic status dropped from one community to the next, the risk for the condition increased 12 percent.

After taking other contributing factors into account, the researchers concluded that 4.8 percent of the disparity in heart failure risk was attributable to neighborhood factors.

But the study did not prove that living in a poor area actually caused heart risk to rise, just that there was an association.

The researchers contend that improving access to community resources — such as fitness facilities and hospitals — would improve the heart health of local residents.

“Increased and improved access to community-level resources could mitigate cardiovascular disease risk factors like obesity, hypertension and diabetes,” said study first author Dr. Elvis Akwo. He’s a postdoctoral research fellow at Vanderbilt.

“Improved community-level resources may ultimately reduce the risk of heart failure in these communities,” Akwo added.

The study was published Jan. 9 in the journal Circulation: Cardiovascular Quality and Outcomes.

More information

The U.S. National Heart, Lung, and Blood Institute has more information on heart failure.