The Socioeconomics of Heart Disease

Low-income heart patients suffer worse outcomes, national study finds

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TUESDAY, June 3, 2003 (HealthDayNews) -- Low-income people are more likely to die or suffer a heart attack after being discharged from the hospital following treatment for a heart attack or unstable chest pain, even though they receive a level of care similar to people with higher incomes.

So says an American study in the June 4 issue of the Journal of the American College of Cardiology.

The study of 2,464 people hospitalized with a heart attack or unstable angina was done by researchers from the Duke Clinical Research Institute in North Carolina, the Cleveland Clinic Foundation and the St. Luke's-Roosevelt Medical Center in New York.

The researchers compared the rates of death within 30 days of hospital discharge and the rates of death or heart attack within six months of leaving the hospital. The people were defined as low-income (less than $20,000 annual household income), middle-income ($20,000 to $60,000), and high-income (more than $60,000).

"When we adjusted for all the potential confounders, we could find no disparity in the way those patients were treated," researcher Dr. Sunil V. Rao, Duke Clinical Research Institute, says in a news release.

"But then when we looked at outcomes, there was a trend toward the low income patients doing worse. They had a higher rate of short and intermediate term death or recurrent myocardial infarction. None of the estimates was statistically significant, because our data set wasn't large enough, but even after adjustment, the point estimates were pretty consistent that low-income patients did worse than patients in the middle-income or high-income categories," Rao says.

Rao suggests low-income patients may have more difficulty paying for medications, they may go back to smoking at a higher rate, or they may have more trouble finding heart-healthy foods and safe places to exercise.

While the study doesn't identify the cause of the higher death rate among low-income heart patients, it does highlight the threat, Rao says.

More information

Here's where you can learn more about heart attack.

SOURCE: Journal of the American College of Cardiology, news release, June 3, 2003

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