Heart Health Indicators Help Explain Poverty-Related Health Disparities

Armen Hareyan's picture

Heart Health and Poverty

People of lower socioeconomic status (SES) are at greater risk of being in poor physical shape and of dying earlier than other individuals from any cause, according to new research conducted by the Cleveland Clinic Department of Cardiovascular Medicine.

In the study led by Cleveland Clinic cardiologist, Michael S. Lauer, M.D., researchers found that impaired functional capacity and abnormal heart rate recovery correlated strongly with lower socioeconomic status. Impaired functional capacity, the ability to perform daily activities such as walking, and abnormal heart rate recovery are indicators of poor cardiovascular health.

The study also found that among patients with poor cardiovascular health, those of a lower socioeconomic status were twice as likely to die in the next ten years as their counterparts in higher socioeconomic groups.

"Our findings suggest that combining individual patient data and socioeconomic data could help physicians more readily identify those individuals at risk for developing fatal heart disease," Dr. Lauer said. "These findings also reinforce the importance of public health initiatives that seek to address social and economic factors that have an impact on health."


The study comprised 30,043 patients from seven Northeast Ohio counties who were referred to the Clinic between 1990 and 2002 for symptom-limited treadmill exercise testing as part of an evaluation for suspected or known heart disease.

The researchers also found that patients in the lowest socioeconomic level were likelier to be from racial and ethnic minority groups, be overweight or obese, and suffer from diabetes, high blood pressure and heart disease. Likewise, the data showed that patients in lower socioeconomic groups were likelier to be unemployed and more likely to be covered by Medicare or Medicaid rather than commercial insurance.

"In a time of increasing health disparities, the public health implications of this study are paramount," Dr. Lauer said. "At the very least, an approach that explicitly addresses the contribution of adverse socioeconomic exposures to health represents a promising strategy for reducing poverty-related health disparities."

Results of the study appear in the Feb. 15 issue of the Journal of the American Medical Association.

Cleveland Clinic Heart & Vascular Institute is the recognized world leader in diagnosis and treatment of cardiovascular disease. Cleveland Clinic has been ranked No. 1 in the nation for cardiac care by U.S. News & World Report every year since 1995. Cleveland Clinic has been ranked among America