• Amulya Arakala

Socioeconomic Status and Cardiovascular Disease

During an American Heart Association meeting in 2009, research teams shown staggering study results, concerning a deadly, yet prevalent chronic disease. Cardiovascular disease (CVD) is the name that refers to a number of conditions related to the heart or blood vessels. Egyptian researchers found evidence that showed coronary artery disease (narrowing of the arteries) after studying mummies - some almost 3,500 years old. This disease, dating back thousands of years ago, is the number one killer in the US, accounting for the near 655,000 deaths every year. Even so, the disease hasn’t yet left the podium. Heart disease is one of the top five most preventable diseases, as it results from unhealthy habits: poor diet, inactivity, alcohol, tobacco smoking, et cetera. Apart from these behavioral risk factors, your neighborhood socioeconomic factors, family household income, and employment status are evidently associated with CVD, as well. Through observation, it has become apparent that socioeconomically disadvantaged groups are more likely to have exposure to common risk factors of CVD than others. Additionally, cardiovascular disease has sparked a rebuttal concerning the widespread inequities in health and SES: less attention is drawn to the rising health partisanships between the rich and poor.


Socioeconomic status (SES) refers to an individual’s income, education, and occupation. Those who have little wealth or income primarily live in neighborhoods with similar individuals - these are the socioeconomically disadvantaged. These groups often show adverse health behaviors, such as smoking, low physical activity, committing to a sedentary lifestyle, drug abuse, and more. After a study in 2015, out of 1.3 million low SES adults who were at least 35, 19% were more likely to get Coronary heart disease.


Smoking, a traditional risk factor, can ideally cause many heart diseases, from blood clots in veins and arteries, and plaque formations. Furthermore, it causes other cardiac difficulties, like increased blood pressure, stroke, irregular heart rhythm, and tightened arteries. Low SES groups pursue tobacco smoking because they are often targeted by marketers in the tobacco industry, have more access to cigarettes, and have a lower support system for quitting.


Beyond daily living, many Americans report less than the average physical activity needed to meet the public health guidelines. Leisure-time physical activity (LTPA) includes sports, walking, at-home exercises, yard work, and biking. Nearly 25 percent of adults report that they do not participate in any LTPA throughout the day. The topic continues to concern many health professionals, as the numbers steadily increase. Families with demanding occupations and on-site jobs, who live in low SES neighborhoods, similarly don’t partake in LTPA. These individuals work longer hours and late-night shifts. They struggle to find space between the clock for childcare responsibilities and community obligations, let alone a personal leisure activity. Despite the infomercials promoting weight loss pills and dieting methods, your body needs regular physical activity, rather than alternatives in order to sustain our most vital muscular organ. A moderate amount of 150 minutes a week of moderate aerobic exercise may help reduce bad cholesterol build-up in the arteries; steering clear of any blockages. Other cardiac defects include the development of high blood pressure, elevated cholesterol, Metabolic syndrome, clogged arteries, abnormal heart rhythm, Marfan syndrome, and heart failure. As mentioned, financially disadvantaged groups are susceptible to inactivity, which may catalyze a number of cardiac malfunctions, as they get older.


Many organizations, research centers, and prevention programs are dedicated to the ample and weighty work still needed to be done, regarding cardiovascular disease. But, an issue of direct relation with heart disease has shown itself evident years ago, and its exigent demands cannot be ignored. The pressing matter is none other than, the widespread health inequities between low and high-income patients. Physicians are studied after visits with both patients, and the impact of their practice and perception has been deplorable on low SES individuals. In the English National Health Service non-emergency procedures, there has been up to a 35% difference (43 days) in waiting times between patients with different socioeconomic statuses. Comparatively, doctors are less likely to discern

patients with a low socioeconomic status as independent, responsible, or sensible. These perceptions have affected clinical decisions made by patients. Physicians avoid referral for special care, necessary medication, and set back diagnostic evaluations. Low SES patients also receive limited check-ups and inadequate care, ignoring and exacerbating their condition. Nearly 90,000 individuals were examined in Australia and New Zealand, and those with a low socioeconomic status (lower educational attainment) had an increased risk of CVD than those with tertiary education. Socioeconomic inequality continues to be a leading challenge with the treatment of hospitalized cardiovascular disease patients, all over the world.


So, how can we prevent it? We can cease the lack of justice in health-care, by addressing the health inequities in policies and programs through written reports. Public health programs can highlight important issues, not covered in the media, by interviewing patients directly. The welfare of our society is dependent on policy changes and health activists, to put an end to the deeply rooted health inequities and social determinants.


Although it seems that health is determined by genetics, lifestyle, and environment, there is, in truth, a diverse and veiled set of factors when it comes to your physical well-being. Socioeconomically disadvantaged groups tend to participate in adverse behavior, further increasing their risk of CVD. Those with low educational achievement or those in impoverished neighborhoods see struggles past their economic or educational title. With inadequate health-care being given to individuals with a low SES, CVD patients’ conditions are helplessly escalating. Once the causes of the disparities in health-care are better understood, we can pursue taking viable steps approaching health equity, to save the millions of hearts at risk.


Works Cited

“Heart Disease Facts.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 8 Sept. 2020, www.cdc.gov/heartdisease/facts.htm.

Schultz, William M., et al. “Socioeconomic Status and Cardiovascular Outcomes.” Circulation, 18 June 2018, www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.117.029652.

Davari, Majid, et al. “Socioeconomic Status, Cardiac Risk Factors, and Cardiovascular Disease: A Novel Approach to Determination of This Association.” ARYA Atherosclerosis, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Nov. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC7073799/.

“Lack of Physical Activity.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Sept. 2019,

www.cdc.gov/chronicdisease/resources/publications/factsheets/physical-activity.htm#:~:text=Fast %

20Facts,beyond%20that%20of%20daily%20living.

Nicholas C. Arpey, Anne H. Gaglioti. “How Socioeconomic Status Affects Patient Perceptions of Health Care: A Qualitative Study - Nicholas C. Arpey, Anne H. Gaglioti, Marcy E. Rosenbaum, 2017.” SAGE

Journals, journals.sagepub.com/doi/full/10.1177/2150131917697439.

Moscelli, Giuseppe, et al. “Socioeconomic Inequality of Access to Healthcare: Does Choice Explain the Gradient?” Journal of Health Economics, North-Holland, 23 June 2017,

www.sciencedirect.com/science/article/pii/S0167629616302545.

“Reducing Health Inequities in a Generation: a Dream or Reality?” World Health Organization, World Health Organization, 4 Mar. 2011, www.who.int/bulletin/volumes/87/2/08-062695/en/.

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