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Racial Gap in Heart Attack Survival Linked to Where You Live

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Racial Gap in Heart Attack Survival Linked to Where You Live

Where you live is a key factor in how likely you are to survive a heart attack — and in the differences seen between white and Black patients in heart attack survival, according to a new study published in the Journal of the American College of Cardiology.

The study involved 31,275 members of the Kaiser Permanente health system in Southern California, as noted in a press release from the organization. Looking at heart attacks between 2006 and 2016, researchers at the health system assigned each patient a neighborhood deprivation score based on their home address and data for what’s known as the Area Deprivation Index, which is based on 17 factors including education level, income, employment status, and household characteristics within a neighborhood. They then compared this score with the risk of survival following a heart attack over an average follow-up period of about five years per patient.

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Race, neighborhood linked to heart attack survival

The researchers found that both race and neighborhood wealth were linked to the risk of heart attack survival, in interrelated ways. For example, in wealthier areas, the chances of surviving a heart attack were similar between white and Black people. But among people who lived in neighborhoods with greater deprivation, Black people were 19% more likely to die following a heart attack than their white counterparts in the same neighborhood.

What’s particularly notable about this study is that participants were members of the same health system and were treated at the same health care facilities for their heart attack and follow-up care, so it’s unlikely that the quality of health care was a factor in the heart attack survival rate. “Despite comparable health care access, Black patients from lower resourced neighborhoods still had higher mortality compared to white patients,” wrote study author Mingsum Lee, MD, PhD, a cardiologist at the Kaiser Permanente Los Angeles Medical Center. “This study suggests that social and environmental factors can affect a person’s outcome after a heart attack, and where a person lives can have a powerful impact on health outcomes.”

Lee noted that these study results are likely to be of interest to health systems, which are typically invested in looking at ways to improve heart attack survival in their patents. They suggest that there are limits to what a health care provider can do to improve heart attack survival or to reduce disparities between white and Black patients, since there’s not much a provider can do to reduce economic disparities between neighborhoods. But by keeping closer track of where patients live, Lee writes, health care systems may be able to better predict how likely they are to survive a heart attack, and may be able to allocate certain resources based on this risk assessment — such as making a greater effort to make sure people who live in these areas have access to lifestyle-based programs.

Still, this study highlights the limited role that health care providers play in certain health outcomes, and suggests that broader policies related to housing, education, and more may have a large impact on health outcomes — including racial disparities in areas like heart attack survival.

Want to learn more about keeping your heart healthy with diabetes? Read “Tips for a Healthy Heart,” “Lower Your Risk of Heart Disease” and “Fight Off Heart Disease With These Five Heart-Healthy Foods.”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

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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