After decades of decline, the rate of deaths from heart disease and stroke has plateaued in recent years, and is actually rising in some populations. For the new study, researchers wanted to see how the economy might fit into the picture, especially in light of the uneven recovery around the U.S. after the 2007-2009 recession.
The study looked at county death rates from cardiovascular disease from 2010-2015 in adults ages 25 to 64. It compared those with each county's Distressed Communities Index. That's made up of seven economic markers, including income, access to housing, how many residents earned high school diplomas, and how many businesses are in the area.
Researchers found cardiovascular death rates in counties with the least economic distress stayed about the same – 62.6 deaths per 100,000 residents in 2010 and 61.5 in 2015. But counties on the flip side fared much worse: Those with the highest amount of distress saw the largest jump in mortality, from 122 to 127.6 deaths per 100,000 people.
The findings underscore how economic disparities contribute directly to health disparities, said lead researcher Dr. Sameed Khatana. He presented the preliminary findings this week at the American Heart Association's Scientific Sessions.
"Large economic trends we might read about in the newspaper - things like recessions and job losses – really do have an impact on certain communities and the cardiovascular health of individuals living in those communities," said Khatana, a cardiovascular fellow at the University of Pennsylvania.
"Policymakers, physicians and patients need to be aware of this increase in mortality rates," he said. "There might be certain interventions that could help either slow down this trend or potentially even reverse it – for example, policies such as health insurance expansion."
Although the current data excluded certain small counties that had very few deaths per year, Khatana said future analysis will include data from those counties.
"This study's findings support the importance of social determinants of health and their impact on bad health outcomes," said Dr. Salvador Cruz-Flores, head of the neurology department at Texas Tech University Health Sciences Center in El Paso.
Cruz-Flores, who was not involved in the research, said the findings highlight the obstacles faced by patients who may have no insurance, no money to buy medication, and who can't exercise outdoors because they live in a dangerous neighborhood. Distressed communities, he said, can be a contributing factor to chronic diseases like diabetes and high blood pressure.
He said he'd like to see data on how different racial and ethnic groups fared - and research on interventions to "narrow the gap" in health disparities.