Lower Income Communities Have Worse Cardiovascular Health Disparities


Increasing interventions for affordable housing and food security could contribute to reduced rates of heart disease in lower income communities.

Rural counties with a higher percentage of Black residents have higher rates of heart disease, despite a general decline in heart disease between 2009 and 2018, according to a paper by researchers at the University of Georgia published in the Journal of the American Heart Association. Housing instability was an important factor that contributed to death from cardiovascular disease (CVD), as was food insecurity.

“Even though the rates of CVD are decreasing, the gaps between rural and urban health and counties with more Black residents are not decreasing,” said lead study author Heejung Son, doctoral student in the College of Public Health at the University of Georgia, in the press release. “The main point of our study is that we need to try to find ways to reduce those gaps.”

Every year, the US Department of Health and Human Services’ Agency for Healthcare Research and Quality conducts an annual survey to understand the link between community-level factors (demographics, socioeconomic status, access to quality health care) and emerging health issues, such as CVD and obesity. The agency has access to data on 3100 counties across the entire United States, with populations varying across demographics and socioeconomics.

Income, housing conditions, transportation, and other social factors can be linked to a person’s health, according to Zhuo “Adam” Chen, co-author of the study, associate professor of health policy and management, College of Public Health. This supports previous findings, which determined that having a low income can create stress that leads to inflammation and illness, thus providing an explanation as to why socioeconomic status can increase risk of death from CVD.

In the current study, investigators collected data from this Department of Health survey. What they discovered is that counties with a higher incidence of CVD had a larger number of residents lived in mobile homes. Conversely, counties with higher household income and access to quality health insurance (Medicare) had lower rates of death from CVD.

The team also ascribes that lower income communities who have more residents that rely on food stamps—as part of the Supplemental Nutrition Assistance Program—had more deaths from CVD. Further, counties in which more residents only completed their high school education appear to fare worse. Chen explained that increasing food stamp availability could help address high rates of CVD in certain communities, although affordable housing and health care require more government action.

“We need to be thinking outside of the box,” Chen said. “This study presents evidence for stronger interventions related to housing, income support and food security. We need to be proactive instead of waiting for people to get sick to provide medical care.”


University of Georgia. Heart disease deaths declining, but not for everyone. News Release. February 21, 2023. Accessed February 22, 2023. https://www.eurekalert.org/news-releases/980342

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