Dollar Signs and EKG Lines: Dallas Heart Disease Study "Striking" For Poor Young People

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We hear a lot about income inequality these days, as we do about our collectively clogged arteries. But it's less often that we're reminded of how one affects the other.

A study in the Canadian Medical Association Journal does just that, tracking the connection between cardiac arrest and income inequality. One of its authors tells Unfair Park that what it says about Dallas is "amazing" -- and not in a good way.

Researchers chose Dallas as one of seven metropolitan areas throughout the United States and Canada. All of the cities participate in a clinical research network called the Resuscitation Outcomes Consortium, and Dallas in particular was able to supply some apparently high-quality data. Not surprisingly, the study found that poor people are more likely to suffer from sudden cardiac arrest -- which in this country has a 5-percent survival rate -- than the affluent.

But that isn't what stunned Dr. Sumeet S. Chugh, the associate director for genomic cardiology at the Cedars-Sinai Heart Institute.

It was this: Dallasites under 65 years old in the lowest income bracket were more than four times as likely to suffer sudden cardiac arrest than those in the highest. The closest runner-up was Portland, Oregon, where the figure was three-and-a-half times as likely.

It seems odd that, in terms of disparity, the biggest gaps are seen in a younger crowd. "Why is it that the under 65 seem to drive this?" Chugh asks, rhetorically. He can't say for sure, but he can offer up a very well-educated guess.

"Can some of these outcomes be a surrogate for race?" he says. "When you see somebody is poor based on median income, could there be minorities that play a larger role in that scenario?"

Lack of health insurance may also figure in, he added. Eligibility for Medicare doesn't start until 65. Last time we checked, there were more than 50 million uninsured people in the U.S. Cardiac diseases go undiagnosed until it's too late. According to the data, aside from Toronto, Canada came out in much better shape. Could its universal health care system be keeping down heart-attack rates among those younger than 65?

"They spend 10 percent of GDP [gross domestic product] on health care," he points out. "We spend 16. Could that be playing a role?"

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Mike
Mike

How could anyone walk around Dallas, ride a bus or train, and see people at a shopping mall and not realize it's all about obesity?  What do expect?  An educated guess - Give me a break.  How many poor people of color that are Bridge clients without routine medical care die of sudden cardiac arrest?  Probably a lot fewer % than the city as a whole.  I see a lot of homeless people, but I don't many obese homeless people. They die of cancer, stroke, organ failure, or even assault before 65, but likely not sudden cardiac arrest. We could spend 30% of GDP on health care and it's not going to fix the wear and tear on your body that being severely obese creates.  All the statins in the world are not going to prevent that inevitable result.  Being obese is a personal decision.  If you want to do something about it, it's your job to fix it.

TimCov
TimCov

1. As has been pointed out, the lower your income the higher your BMI is likely to be. This is one risk factor.2. (Personal observation) It seems like the lower a person's income is, the more likely that person is to be a heavy smoker. I have not seen studies on this. It is just a personal observation. But, it could be a factor.3. If you are uninsured (and the lower your income, the more likely this is), you are less likely to routinely see a doctor. This can lead to precursors to heart disease (high blood pressure and high cholesterol) from being diagnosed and treated.4. Generally lower income people do not partake in a routine physical fitness regimen (for a variety of reasons). Often, they are working 2 jobs (so no time). They might perceive a gym, special clothes or equipment as being necessary and expensive (it is not necessary). 5. The cost of and availability of healthy food can be to expensive unless you grow your own vegetables or you are very careful in your shopping.

Jnutter
Jnutter

This is also a fatally flawed oversimplification of the health care delivery system as well as the underlying mechanism of myocardial infarction and-- dare I say- another example of template driven journalism meets junk science.  Many Vietnam and Iraqi war vets are "below 65" years of age and a high percentage in the southwest/nationally belong to minority groups.  These groups all have access to VA Hospitals (much as native Americans have access to Public Health funded care) many of which(hospitals) are affiliated with good university medical schools. Most VA hospitals are in urban areas or are accessible otherwise.   Therefore ,"poverty" per se and "lack of access" to health insurance as well as percentage of GDP spent on health care should not be implicated in this scenario.  The premise is flawed and overreaching. Don't worry folks, rationing of health care is coming covertly and overtly, due largely to phoney media template driven propaganda such as this, the "need" for the govt. to control potential voters and the need for the insurance companies to seek a better business model in order to rake in even more profits (at the expense of your well being). 

Facebook User
Facebook User

Studies show that obesity correlates closely with income. The lower the income the higher the BMI. Higher BMI means a significantly increased risk of heart disease. Solve obesity and you will have solved heart disease.

gladnotsad
gladnotsad

Oh come on. I just got back from a cardiology meeting and I can tell that this "researcher's" data pool is extremely selective and flawed. Unfortunately, Native Americian populations are usually below the poverty line (yes they have Native populations in Canada), and infarcts, especially of the "sudden death" variety are relatively rare  within that population. Perhaps the "research" should extend outside the urban confines.

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