Economic Status, Lifestyle Linked to Cardiovascular Risk

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Economic Status, Lifestyle Linked to Cardiovascular Risk

A lower socioeconomic status — having less income and wealth — is linked to a higher risk of cardiovascular disease and death, but lifestyle factors also play a role in these risk levels, according to a study published in the journal The BMJ.

The researchers looked at data from 44,462 adults ages 20 and older in the United States, as well as 399,537 adults ages 37 to 73 in the United Kingdom, covering an average follow-up period of about 11 years. Participants with a low socioeconomic status had a higher risk of overall death, compared with adults with a high socioeconomic status — 2.13 times as high in the U.S. group, and 1.96 times as high in the UK group. Participants with a low socioeconomic status in the UK group were also 2.25 times as likely to die from cardiovascular causes, and 1.65 times as likely to experience cardiovascular disease. Socioeconomic status was designated at one of three levels — low, medium, and high — based on family income, occupation, education level, and (for the U.S. group only) health insurance status.

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Effects of lifestyle limited compared to socioeconomic status

On top of these poor outcomes linked to socioeconomic status, certain lifestyle factors were found to play a role in the risk of death. Healthy lifestyle scores were based on never smoking, not consuming a high amount of alcohol, and following a healthier diet. Among participants with a low socioeconomic status who had no or just one healthy lifestyle factor, the risk of death was 3.53 times as high in the U.S. group and 2.65 times as high in the UK group compared with participants with a high socioeconomic status who had three or four healthy lifestyle factors. In the UK group, the risk for death from cardiovascular disease was 2.65 times as high, and the risk for cardiovascular disease was 2.09 times as high. For each additional healthy lifestyle factor that participants had, the risk for death and cardiovascular disease dropped by 11% to 17%, as noted in a Healio article on the study.

The researchers concluded that while lifestyle factors had some impact on the risks for death and cardiovascular disease among participants, this effect was limited compared with underlying socioeconomic differences. Therefore, they wrote, “healthy lifestyle promotion alone might not substantially reduce the socioeconomic inequity in health, and other measures tackling social determinants of health are warranted.” Still, the results showed that supporting health lifestyle changes could lead to improved health and mortality outcomes regardless of a person’s socioeconomic status.

Limitations of this study, the researchers noted, included the fact that socioeconomic status was based on self-reported responses and was calculated only once — even though it could change over the course of 11 years. They also noted that both lifestyle factors and socioeconomic status could be determined, in part, by underlying serious diseases that were present at the start of the study, which could also affect a person’s risk for death and cardiovascular disease outcomes.

Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”

Living with type 2 diabetes? Check out our free type 2 e-course!

Quinn Phillips

Quinn Phillips

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A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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