Heart Disease Risk Linked to Income, Not Access to Healthy Food

Higher-income individuals living in low-income areas had lower cardiovascular risks than those with lower incomes.

The risk of heart disease can be inherited or a result of lifestyle choices, such as a lack of exercise and eating unhealthy foods.

The risk of heart disease may also be associated with a lower income, rather than access to healthier foods, according to a study published by Circulation: Cardiovascular Quality and Outcomes.

The study focused on the effect of income, education, and socioeconomic status of healthy individuals living in Atlanta in urban food deserts.

Urban food deserts are defined by the USDA as an area that is low income and has limited access to healthy food. These are areas in which a significant amount of the population lives more than 1 mile away in urban areas or 10 miles away in rural areas from a grocery store.

Included in the study were 1421 patients who participated in the META-Health study and the Predictive Health study. Patients were aged 20 to 70 years, 38.5% were men, and 36.6% were black. The authors examined demographic data, metabolic profiles, and heart disease signs, including inflammation and arterial stiffness.

The authors discovered that patients living in food deserts had increased rates of smoking, high hypertension, high body mass index, and arterial stiffness compared with patients not living in food deserts, according to the study.

These risk factors were then examined in terms of average neighborhood income and individual income.

The authors found that people living in food deserts in low income areas were not observed to have significant differences in markers for heart disease compared with those in areas with low income but good food access, according to the study.

Notably, people with higher incomes living in low income areas had lower cardiovascular risks compared with lower income patients in similar areas.

Additionally, patients with high incomes living in an area with limited access to healthy food had a better cardiovascular profile compared with lower-income individuals living in similar areas, according to the study.

These results suggest that individual income may be the most important risk factor for heart disease, according to the study.

The authors note that additional studies should include a large group of patients that follow them for a longer period of time.

“At least in the urban environment, the definition of a food desert wasn't sufficient to explain poor health in terms of cardiovascular risk factors,” said senior author Arshed A. Quyyumi, MD, FACC, FRCP. “This study shows that low personal income and low socioeconomic status matter when it comes to cardiovascular disease risk. Physicians need to be aware that these social determinants increase disease risk and that perhaps more attention needs to be paid to patients who fall into this category.”