Wealthy, well-educated Americans have far lower rates of heart disease than less-educated people with lower incomes, according to a new study.
The top 20% of high-income, college-educated Americans are significantly less likely to have cardiovascular disease — the leading cause of death in the United States — than the rest of the population, research shows.
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Americans in lower income brackets who lack college degrees are six times more likely to develop congestive heart failure than wealthy, high-educated Americans. Their risk of stroke is three times higher, and their risk of heart attack and angina — a type of chest pain indicative of coronary artery disease — is twice as high.
"The accumulation of economic and educational advantages appears to drive better health outcomes, rather than any single factor alone," Salma Abdalla, an assistant professor of public health at Washington University in St. Louis, said in a release. "Wealth and education cluster among a small, advantaged group, while the majority of Americans face an increased risk of heart disease."
The researchers found that even when they controlled for demographics and health markers including body mass index, blood pressure and cholesterol levels, the disparities in heart health outcomes remained.
"The continued widening of health disparities in the U.S. underscores the need for action," said researcher Dr. Sandro Galea, a population health scientist at Washington University. "If we want to improve public health outcomes, we must address the root causes — economic opportunity, education and access to resources that support long-term health."
The study examined data from nearly 50,000 people who were part of the National Health and Nutrition Examination Survey between 1999 and 2018. Researchers grouped people by education and income levels and looked at the prevalence of congestive heart failure, angina, heart attack and stroke.
Key risk factors for cardiovascular disease include high blood pressure, high cholesterol and smoking. Excessive drinking, obesity and diabetes also put people at higher risk of cardiovascular disease, according to the Centers for Disease Control and Prevention.
According to the CDC and the American Heart Association:
• Cardiovascular disease, including heart disease and stroke, kills more people each year in the United States than all cancers and accidental deaths combined.
• One person dies of cardiovascular disease every 34 seconds in the United States. That is nearly 2,500 people a day.
• Coronary artery disease is the most common type of heart disease. It killed more than 370,000 people in 2022.
• Someone has a heart attack every 40 seconds in the United States. One in five heart attacks are silent, causing blockage of blood flow to the heart and potential damage to the heart muscle without the person knowing.