Low Income Linked to Post-Heart Attack Death

Each $10,000 increase associated with 10 percent drop in risk; less education also linked with risk

THURSDAY, June 19 (HealthDay News) -- Residing in a neighborhood with low income is associated with a higher risk of mortality following a myocardial infarction, according to research published in the June issue of the Mayo Clinic Proceedings.

Yariv Gerber, Ph.D., of the Mayo Clinic in Rochester, Minn., and colleagues analyzed data from 705 residents of Olmsted County, Minn., who'd had a myocardial infarction. The researchers assessed subjects' education and neighborhood median household income. Subjects were followed for a median 13 months, during which time 155 died.

Neighborhood income was associated with mortality risk, with a hazard ratio of 2.10 for the lowest versus highest tertile. Each $10,000 increase in neighborhood income was associated with a 10 percent decrease in mortality risk, the investigators found. Individual education was also associated with mortality risk (hazard ratio 2.21 for less than 12 years versus more than 12 years), though this association was markedly reduced after adjustment for multiple variables.

"The strong association shown between neighborhood income and death suggests a contextual effect. Alternatively, neighborhood income could merely act as a proxy for unmeasured dimensions of individual-level socioeconomic status. We think both mechanisms are likely to have a role. The association observed for education could be related to its indirect positive effect on job opportunities, income, housing, access to nutritious foods, health insurance and more," the authors write. "As recently reported, education is strongly associated with health literacy, which in turn affects one's ability to obtain, process and understand basic health information and services needed to make appropriate health decisions."

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