Breaking News
February 21, 2018 - ESRD Death Declines in Vasculitis Patients
February 21, 2018 - Taking ibuprofen for long periods found to alter human testicular physiology
February 21, 2018 - Google AI device could predict a person’s risk of a heart attack
February 20, 2018 - FDA Approves Domestic Source for Tc-99m Isotopes
February 20, 2018 - Sanofi rejects refund demand faces Philippine suit over dengue vaccine (Update)
February 20, 2018 - Researchers discover that activation of specific enzyme may help suppress tumor metastasis
February 20, 2018 - Blood or marrow transplantation survivors have higher risk of cognitive impairment
February 20, 2018 - Booze Beats Pot at Being Unhealthy: Oregon Poll
February 20, 2018 - Morning Break: ’20 Years Late’; Drugs in the Dirt; Catching Flu in the Dorm
February 20, 2018 - Another piece to the puzzle in naked mole rats’ long, cancer-free life
February 20, 2018 - Scientists identify four viruses that can produce insulin-like hormones
February 20, 2018 - New e-Health solution developed to prevent cardiovascular disease, dementia in senior citizens
February 20, 2018 - New genetic risk score could help guide screening decisions for prostate cancer
February 20, 2018 - Study finds higher risk of stroke among blacks with atrial fibrillation than whites
February 20, 2018 - Physical activity could be used as strategy for diabetes prevention
February 20, 2018 - Researchers develop sensing method for early detection of cancer and diabetes
February 20, 2018 - New wearable electronics could be game-changer for stroke rehabilitation
February 20, 2018 - Immune history influences person’s response to flu vaccine
February 20, 2018 - Serenity Now! Learn to Have Patience with Patients
February 20, 2018 - Computer simulation addresses the problem of blood clotting
February 20, 2018 - Women with type 1 diabetes not protected against coronary artery disease
February 20, 2018 - Persistent bloating can be a sign of ovarian cancer, warns charity
February 20, 2018 - Trump administration proposes rule to loosen curbs on short-term health plans
February 20, 2018 - Key protein involved in epigenetic regulation of gene expression guides skin cell renewal
February 20, 2018 - Heart attack symptoms often missed in women
February 20, 2018 - Diagnosis of celiac disease takes 3.5 years for patients who do not report GI symptoms
February 20, 2018 - Study reveals functional dynamics of ion channels
February 20, 2018 - Study explores link between mortality risk and combustible tobacco use
February 20, 2018 - ‘She Trusted Me, and I’d Turned Her Away’
February 20, 2018 - AbbVie and Voyager Therapeutics collaborate to develop new treatments for tauopathies
February 20, 2018 - Fast food makes the immune system more aggressive in the long term
February 20, 2018 - Therapeutic target for glaucoma could have treatment ramifications for Alzheimer’s and Parkinson’s
February 20, 2018 - Overcoming Negative Reviews | Medpage Today
February 20, 2018 - MyD88—villain of allergies and asthma
February 20, 2018 - Food scientists develop rapid screening technique to detect pesticide residue in vegetables
February 20, 2018 - Lab-grown cerebellar cells may help explain how ASD develops at molecular level
February 20, 2018 - Scientists explore connection between bad sleep habits and stiff blood vessels
February 20, 2018 - New Treatment Apalutamide (Erleada) Approved for Prostate Cancer That Resists Hormone Therapy
February 20, 2018 - Do You Really Need My Signature on That?
February 20, 2018 - HIV-1 genetic diversity is higher in vaginal tract than in blood during early infection
February 20, 2018 - Diabetes does not increase work-loss years due to early retirement
February 20, 2018 - Researchers aim to find out how PTSD affects decisions of police
February 20, 2018 - UH Cleveland Medical Center explores novel treatments for uterine fibroids
February 20, 2018 - Flu Vax Efficacy 25% Against Predominant H3N2 Strain So Far
February 20, 2018 - HIV screening most optimal at 25 years of age if no risk factors
February 20, 2018 - Loyola Medicine primary care physician offers advice to minimize risk of flu
February 20, 2018 - Safe sleep recommendations for parents that may help reduce child’s risk of SUID
February 20, 2018 - Why Do So Few Docs Have Buprenorphine Waivers?
February 20, 2018 - Low levels of alcohol good for the brain
February 20, 2018 - Experimental treatment improves invisible symptoms of a man with spinal cord injury
February 20, 2018 - Myriad’s EndoPredict offers better prediction of breast cancer recurrence, analysis shows
February 20, 2018 - Researchers identify fifteen genes that determine our facial features
February 20, 2018 - Morning Break: New Health IT Player; Luxturna No Bargain; Nuclear Freakout
February 20, 2018 - How does it compare? Hospice care at home, at assisted living facility, at nursing home
February 19, 2018 - Scientists develop water-soluble warped nanographene for bioimaging
February 19, 2018 - It’s Not Your Imagination: You’re Hungrier After Losing Weight
February 19, 2018 - Antihypertensive Use At Delivery Rising in Preeclampsia
February 19, 2018 - A centuries-old math equation used to solve a modern-day genetics challenge
February 19, 2018 - Liquid biopsies could be used as new predictive marker for metastatic TNBC
February 19, 2018 - Russian researchers develop new multi-layered biodegradable scaffolds
February 19, 2018 - Are ‘Vaccine Skeptics’ Responsible for Flu Deaths?
February 19, 2018 - Hidden genetic effects behind immune diseases may be missed, study suggests
February 19, 2018 - Emergency nurses experience regular verbal and physical abuse
February 19, 2018 - Study sheds light on biology that guides behavior across different stages of life
February 19, 2018 - Morning Break: Transgender Breast Feeding; Brazilian ‘Pro-Vaxxers’; Post-Stroke Exercise
February 19, 2018 - Meningitis vaccination strategy in Africa found to be effective, economical
February 19, 2018 - Researchers uncover how excess calcium may influence development of Parkinson’s disease
February 19, 2018 - Psoriasis drug also effective at reducing aortic inflammation
February 19, 2018 - Excess emissions can make serious contributions to air pollution, study shows
February 19, 2018 - Researchers reveal potential biological roots behind individuality
February 19, 2018 - Diabetes Drugs Differ on HF; School-Based Obesity Program Flop; Plaque Type in ACS
February 19, 2018 - Surgical infections linked to drug-resistant bugs, study suggests
February 19, 2018 - Poor awareness may hinder a child’s early dental care
February 19, 2018 - Research finds rising trend in incidence of merkel cell carcinoma
February 19, 2018 - Researchers uncover Ras protein’s role in uncontrolled cancer growth
February 19, 2018 - FDA Approves Apalutamide (Erleada) to Help Curb a Tough-to-Treat Prostate Cancer
February 19, 2018 - Educational Tool Boosts Cervical Length Screening
February 19, 2018 - Spider’s web inspires removable implant that may control type 1 diabetes
February 19, 2018 - Scientists develop fluorescent probe to identify cancer stem cells
February 19, 2018 - University Hospital of Santiago de Compostela participates in large pancreatic cancer study
Neighborhood Deprivation Linked to Heart Failure

Neighborhood Deprivation Linked to Heart Failure

image_pdfDownload PDFimage_print

Action Points

  • Neighborhood socioeconomic factors significantly predict heart failure (HF) incidence independent of individual income and education level and traditional CVD risk factors, based on a study among low-income people in the southeastern United States.
  • Note that prior studies have shown a strong independent association between living in poverty and heart failure risk, but this study is among the first to assess risk at a community level in a solely low-income population.

Living in impoverished neighborhoods with few resources was found to be a risk factor for heart failure that was independent of individual socioeconomic status and cardiovascular risk in a newly published study.

Neighborhood deprivation was a significant predictor of heart failure incidence along with individual income, education level and other recognized cardiovascular risk factors in the analysis, published online in Circulation: Cardiovascular Quality and Outcomes.

The findings add to the evidence that addressing the lack of community-level resources in impoverished neighborhoods may have a “wide-reaching, population-level effect on mitigation of adverse cardiovascular outcomes including heart failure,” wrote researcher Elvis Akwo, MD, PhD, Loren Lipworth, ScD, and colleagues from Vanderbilt University School of Medicine, Nashville, Tennessee.

“Public policy has a big role to play in improving the health of populations,” Akwo told MedPage Today, “If you encourage one person to exercise more that will impact that person. But if you provide resources to make it easier to exercise in areas with neighborhood deprivation, that could have a wide-reaching impact.”

Prior studies have shown a strong independent association between living in poverty and heart failure risk, but the study is among the first to assess risk at a community level in a solely low-income population.

The researchers did this by examining data from the Southern Community Cohort Study (SCCS), which recruited low-income participants from 12 states in the southeastern United States.

“Within this cohort, we testing the hypothesis that neighborhood characteristics (defined by a composite deprivation index) predict the risk of incident heart failure beyond individual socioeconomic status,” the researchers wrote.

The analysis included data on 27,078 whites and blacks recruited into the SCCS during 2002 to 2009 who had no history of heart failure and were on Medicare or Medicaid.

The neighborhood deprivation index was constructed using principal components analysis based on census tract level socioeconomic variables. Cox models with Huber–White cluster sandwich estimator of variance were used to investigate the association between neighborhood deprivation index and heart failure risk.

The mean age of those included in the analysis was 55.5 years, 69% were black, 63% were female and 70% earned less than $15,000 a year.

More than 50% of participants lived in the most deprived neighborhoods (third neighborhood deprivation index tertile).

Among the main findings:

  • 16% of participants were diagnosed with heart failure during median 5.2 years of follow-up
  • After stratifying the neighborhood deprivation index scores into quartiles, each succeeding quartile was associated with a 12% increase in risk of heart failure (HR 1.12; 95% CI 1.07–1.18), adjusted for demographic, lifestyle, and clinical factors
  • Neighborhood deprivation index scores represented 4.8% of the variance in heart failure risk

Akwo said the study was not designed to determine which specific factors associated with neighborhood deprivation contribute to increased cardiovascular risk, but prior research has shown that food deserts and lack of easy access to healthcare and sidewalks are linked to poorer community health.

In an editorial published with the study, Wayne Rosamond, PhD, and Anna Johnson, PhD, of the University of North Carolina at Chapel Hill, wrote that including only low-income participants in the study was a major strength because it greatly limited the potential for bias associated with individual stressors linked to living in poverty.

“The focus on an underserved population increases the paper’s relevance to broad public health goals such as the American Heart Association’s impact goals to improve the cardiovascular health of all Americans by 20% by 2020,” they wrote.

The direct measurement of heart failure using event analysis data, rather than medical claims data, was also cited as a study strength.

Rosamond and Johnson concluded that the study “challenges us to consider what types of interventions can be developed at the neighborhood level to reduce the burden of heart failure.”

“As the authors note, such ‘upstream measures’ designed to address the physical, social, and emotional stressors of disadvantaged residential environments have the most potential to reverse the growing burden of heart failure in the U.S.,” they wrote.

Funding for the SCCS was provided by the National Cancer Institute and the American Recovery and Reinvestment Act.

The researchers declared no relevant relationships with industry related to this study.


Tagged with:

About author

Related Articles