White adults benefit the most from high socioeconomic status compared to Black, Hispanic and Asian adults in the US, according to a new study published in the Journal of the American Heart Association .
Research Highlights:
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Improvements in socioeconomic status (education, income, employment status, and health insurance) in ideal cardiovascular health may not benefit people of all racial/ethnic groups equally, as white adults were more likely to benefit than white adults. Black, Hispanic, and Asian adults in the U.S., according to new research published in the Journal of the American Heart Association , an open-access, peer-reviewed journal of the American Heart Association.
"The goal of economic interventions and social policies, such as improving employment, access to health care, and education, is that they lead to improvements in health for all," explained the study’s lead author, Joshua J. Joseph. , MD, MPH, FAHA, an associate professor of internal medicine at The Ohio State University College of Medicine in Columbus. "However, our study found that improvements in these socioeconomic interventions may not benefit people of all racial or ethnic groups equally."
Researchers suggest that additional factors, including psychosocial stress experienced by people from different groups due to racism, medical mistrust, and/or unequal access to care, may also drive inequalities in cardiovascular health.
This study evaluated measures of socioeconomic status with the American Heart Association’s Life’s Essential 8 metrics of ideal heart health in racial and ethnic groups in the United States using diverse and nationally representative data from the National Health Examination Survey and Nutrition (NHANES 2011-2018) for about 13,500 adults.
The analysis found that across all participants, higher socioeconomic status was linked to better heart health, as indicated by higher average scores on the Life’s Essential 8, which has a scale from 0 to 100. However, this link was higher among white adults compared to people from other racial and ethnic groups. For example:
College education was associated with a 15-point increase in ideal heart health scores among white adults, compared with an approximately 10-point increase in ideal health scores for black and Hispanic adults and an approximately 8-point increase in ideal heart health scores among white adults. points among Asian adults.
Medicaid versus private health insurance was associated with a 13-point decrease in Life Essential 8 scores among white adults, compared with a 5- to 6-point decrease for people from other racial and ethnic groups.
The study had several limitations , including the fact that it failed to prove cause and effect between socioeconomic status and the Life’s Essential 8 score. It also did not include information on the potential effects of wealth or racism over time; data were based on self-reported information; and the study did not differentiate between country of birth or immigration status.
Clinical perspective
What’s new?
The association between socioeconomic status and cardiovascular health is greater in magnitude among non-Hispanic white Americans compared to non-Hispanic black Americans, non-Hispanic Asian Americans, and Hispanic Americans.
What are the clinical implications?
Improving socioeconomic status is beneficial for all populations, but may have different magnitudes of effect in different races and ethnicities; therefore, multiple approaches may be necessary to promote equity in cardiovascular health.
The study was funded in part by the Robert Wood Johnson Foundation and the American Heart Association’s Strategically Focused Research Network on Biological Pathways of Chronic Psychosocial Stressors in Cardiovascular Health.
