Income inequality and risk of heart attack: longitudinal findings from the US

Heart attack is the leading cause of death in the US and there is a significant relationship between income and risk for cardiovascular disease. A lot of cross-sectional studies have linked income inequality with behaviours such as smoking and inactivity as well as with coronary heart disease risk factors.

We are very happy to annoounce that we just published one of the first studies to investigate the prospective association between US state-level income inequality and heart attack in a representative sample of US adults. Data was taken from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). 

Data from 43,093 adults at baseline and 34,445 at follow-up was analyzed. The main results can be summarised as follows:

  • Income inequality is an important predictor of an increased risk of heart attack and obesity but not of any of the other coronary heart disease indicators, such as smoking, hypertension or other weight status (after adjusting individual- and state-level characteristics.
  • Income inequality is associated with excess mortality and risk of poor self-rated health.
  • There was no evidence of cross-level interaction between income inequality and sex.
  • Inequality is associated with new onset of disease as well as disease prognosis
  • Responders living in more unequal states were significantly more likely to have a heart attack at follow-up.

What do you think about these results? We welcome your comments!



* This study was written by Roman Pabayo , Ichiro Kawachi and Stephen E. Gilman from the Harvard T.H. Chan School of Public Health , the University of Nevada and Massachusetts General Hospital.

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