Often overlooked, a person’s financial and social status, known as social determinants of health, can offer valuable information about their risk of cardiovascular disease. New research presented at the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology has found evidence that these social determinants can play a role in a person’s risk of heart disease.
This new study suggests that considering these factors as part of medical records and decision making could help address health issues.
Tarang Parekh, MBBS, an assistant researcher in the Department of Health Administration and Policy at George Mason University and lead author of one of the studies said, “We are very focused on addressing certain cardiovascular risk factors, but we forget about factors such as food, housing and financial security that often play a major role in the development of cardiovascular disease. We are not investing enough to address these issues. We must start addressing patients’ problems from a broader perspective to better reduce the toll of cardiovascular diseases.”
For the study, Parekh and colleagues analyzed 2017 data from more than 400,000 U.S. adults in the Behavioral Risk Factor Surveillance System. This large phone-based survey has been conducted annually for more than 35 years.
Researchers examined how participants’ perceptions of their levels of food, financial security, and housing related to their likelihood of having various forms of heart disease including heart attack, stroke, coronary artery disease, and congestive heart disease. Overall, nearly 1 in 10 of the participants reported having at least one form of heart disease when the study began.
Social Factors Independently Associated
After adjusting for demographic factors, socioeconomic status, and known heart disease risk factors, researchers found several social factors to be independently associated with an increased risk of heart disease. It was concluded that housing and food insecurity increased the risk of heart disease by more than 50%, and those with limited access to health care increased the risk by 47%. Those with a high degree of financial insecurity were more than twice as likely to have heart disease compared to those who considered themselves financially secure.
Researchers believe that there are several possible reasons for the associations between social factors and cardiovascular disease risk. Food insecurity could make it difficult to maintain a heart-healthy diet while financial stress could trigger physiological effects that contribute to heart disease. Those with limited access to health care can cause people to delay care until a cardiovascular problem is more advanced and harder to control.
“Recently, health care systems have been considering adding questions relevant to social determinants of health to electronic health records, which would be a really good step,” Parekh said. “In addition, some physicians have started asking questions about the challenges patients may be facing in terms of food, housing, and finances and collaborating with non-profit and community organizations to address these issues in addition to other cardiovascular risk factors a patient has.”
Although this study was limited by a potential bias in sample selection and its reliance on self-reporting by participants, it was able to give a better idea of the risk of cardiovascular disease linked to social determinants. Researchers plan to further investigate the link between heart disease and social factors including timing of any health problems, which will help to develop new treatments and lower the risk for cardiovascular disease.