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Living in poor neighborhoods could increase heart failure risks

KATHMANDU — People living in the poorest neighborhoods have a higher risk of heart failure regardless of their socioeconomic status, the US study has suggested.

In addition to people’s income and education level, the neighborhood in which they lived helped predict their risk, according to the researchers.

Previous research has linked heart failure with a person’s individual socioeconomic status, a general term which includes income, education and occupation. But this new study, published Tuesday in Circulation: Cardiovascular Quality and Outcomes, shows that deprived neighborhoods themselves may play a role in higher heart failure rates.

The study suggested that the availability of gyms, places to buy healthy foods and medical facilities accounted for nearly 5 percent of the increased heart failure risk in low-income areas. The researchers also noted that improving access to these resources could benefit people living in these neighborhoods.

“It simply matters where you live,” said the study’s lead author Dr Elvis Akwo, a postdoctoral research fellow at Vanderbilt University Medical Center in Nashville, adding, “Improving a person’s individual condition isn’t enough.”

Dr Akwo and fellow researchers at Vanderbilt looked to find out if a neighborhood deprivation index — a cluster of 11 social and economic factors — can predict the risk of heart failure beyond individual socioeconomic status in a low-income population.

The study included 27,078 whites and blacks living in low-income neighborhoods who were recruited as part of the Southern Community Cohort Study, a study of chronic diseases in the southeastern United States.

Participants were predominantly middle-aged and poor: 70 percent earned less than $15,000 a year. They were put into three groups, ranging from the least-deprived to the most-deprived neighborhoods.

Most of the participants were underinsured and lived in areas with limited resources. More than half lived in the most deprived neighborhoods and 75 percent earned less than $15,000 a year. Around 39 percent did not have a high school diploma, and 44 percent were obese.

“There is existing evidence suggesting strong, independent associations between personal socioeconomic status — like education, income level and occupation — and risks of heart failure and many other chronic diseases,” said study author Loren Lipworth, who is an associate professor of epidemiology at Vanderbilt University Medical Center in Nashville, in a news release from the American Heart Association.

During an average follow-up period of more than five years, 4,300 people were diagnosed with heart failure. Those living in low-income areas were at highest risk for heart failure. The researchers noted that as socioeconomic status dropped from one community to the next, the risk for the condition increased 12 percent.

After taking other contributing factors into account, the researchers concluded that 4.8 percent of the disparity in heart failure risk was attributable to neighborhood factors.

But the study did not prove that living in a poor area actually caused heart risk to rise, just that there was an association.

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