Lower socioeconomic status is associated with higher coronary heart disease mortality rates than higher socioeconomic status, and more than half of the disparities can be explained by four unhealthy behaviors. Dr. Yachen Zhu of the Alcohol Research Group in the United States and Dr. Charlotte Probst of the Centre for Addiction and Mental Health in Canada report these findings in a new study published September 17th in the open access journal PLOS Medicine.
Coronary artery disease, also known as coronary artery disease or ischemic heart disease, occurs when the arteries supplying the heart cannot supply enough oxygen-rich blood due to plaque buildup, and is a leading cause of death in the United States. The disease poses a higher risk for people with lower socioeconomic status, but previous studies have reported conflicting results about whether certain unhealthy behaviors, such as smoking, are primarily responsible for the observed disparities in deaths from the disease.
In the new study, the researchers used data from 524,035 people aged 25 and older whose mortality status was recorded in the National Death Index and who responded to the National Health Interview Survey on Demographics and Health Behaviors. The team used education as the primary indicator of socioeconomic status and looked at four behavioral risk factors: smoking, alcohol consumption, physical inactivity, and BMI. Together, these four factors explained 74% of the differences in risk of coronary heart disease mortality among men of different socioeconomic levels and 61% among women.
The researchers conclude that their findings underscore the need for effective public health policies and interventions that address each of these behaviors—separately and together—because unhealthy behaviors are often concentrated among individuals from lower socioeconomic backgrounds. They urge public health campaigns to raise awareness of heart health with tailored messages and outreach efforts for both male and female audiences. The authors add:These efforts are essential to reducing socioeconomic disparities in coronary heart disease deaths in the United States.
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