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The
Socioeconomics of Heart Disease
(HealthScoutNews)
-- Low-income people are more likely to die or suffer a heart
attack after being discharged from the hospital following treatment
for a heart attack or unstable chest pain, even though they receive
a level of care similar to people with higher incomes.
So says an American study in the
June 4 issue of the Journal of the American College of Cardiology.
The study of 2,464 people hospitalized
with a heart attack or unstable angina was done by researchers
from the Duke Clinical Research Institute in North Carolina, the
Cleveland Clinic Foundation and the St. Luke's-Roosevelt Medical
Center in New York.
The researchers compared the rates
of death within 30 days of hospital discharge and the rates of
death or heart attack within six months of leaving the hospital.
The people were defined as low-income (less than $20,000 annual
household income), middle-income ($20,000 to $60,000),
and high-income (more than $60,000).
"When we adjusted for all
the potential confounders, we could find no disparity in the way
those patients were treated," researcher Dr. Sunil V. Rao,
Duke Clinical Research Institute, says in a news release.
"But then when we looked at
outcomes, there was a trend toward the low income patients doing
worse. They had a higher rate of short and intermediate term death
or recurrent myocardial infarction. None of the estimates was
statistically significant, because our data set wasn't large enough,
but even after adjustment, the point estimates were pretty consistent
that low-income patients did worse than patients in the middle-income
or high-income categories," Rao says.
Rao suggests low-income patients
may have more difficulty paying for medications, they may go back
to smoking at a higher rate, or they may have more trouble finding
heart-healthy foods and safe places to exercise.
While the study doesn't identify
the cause of the higher death rate among low-income heart patients,
it does highlight the threat, Rao says.
More information
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Reference
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