A new study highlights a widening gap in heart disease risk across the United States, showing that wealth and education play a crucial role in determining cardiovascular health.
The research, published in The Lancet Regional Health—Americas, reveals that high-income, college-educated Americans have far lower rates of heart disease compared to the rest of the population.
Over the past two decades, these disparities have grown even wider.
Cardiovascular disease (CVD) is still the leading cause of illness and death in the U.S.
However, this study shows that the top 20% of wealthier, more educated individuals are seeing better heart health, while the remaining 80% continue to face high risks.
This trend reflects the country’s increasing wealth gap and highlights how economic and educational advantages contribute to long-term health.
The study, led by Dr. Salma Abdalla from Washington University in St. Louis, analyzed data from nearly 50,000 adults over a 20-year period (1999–2018). The researchers used information from the National Health and Nutrition Examination Survey to examine four major heart-related conditions: congestive heart failure, angina (chest pain from heart disease), heart attacks, and strokes.
Their findings showed that people with lower incomes and no college degree had significantly higher odds of developing these conditions compared to their wealthier, college-educated peers. Specifically, low-income non-college graduates were:
- 6.34 times more likely to develop congestive heart failure
- 2.11 times more likely to experience angina
- 2.32 times more likely to have a heart attack
- 3.17 times more likely to suffer a stroke
These disparities remained even after researchers adjusted for factors like age, body weight, blood pressure, and cholesterol levels. This means that the differences in heart health are not just due to personal health choices but are deeply tied to socioeconomic factors.
Why Does Wealth and Education Matter for Heart Health?
The study suggests that economic and educational advantages build up over a lifetime, leading to better overall health outcomes. People with higher incomes and more education often have:
- Better access to quality healthcare: They receive more consistent medical care, earlier diagnoses, and better treatment.
- Healthier lifestyles: They are more likely to engage in heart-healthy behaviors like regular exercise, better nutrition, and stress management.
- More financial stability: Economic security reduces chronic stress, which is a major risk factor for heart disease.
- Safer environments: Higher-income individuals tend to live in areas with cleaner air, lower exposure to toxins, and access to recreational spaces.
- Stronger social support networks: Having a support system can improve mental and emotional well-being, which also affects heart health.
The Bigger Picture: Health Disparities in the U.S.
Despite spending more on healthcare than any other high-income country, the U.S. continues to see worsening health outcomes, especially among lower-income populations.
The study points out that the richest 1% of Americans now live 10 years longer than the poorest 1%. These growing health gaps suggest that medical care alone is not enough to fix the problem.
Dr. Abdalla emphasized that improving heart health requires more than just better healthcare access. “If we want to reduce heart disease, we need to focus on economic opportunity and educational equity,” she said. This means addressing the structural barriers that prevent people from achieving financial stability and quality education.
Dr. Sandro Galea, a co-author of the study, also highlighted the urgent need for policy changes. “Health disparities in the U.S. are widening. If we want to improve public health, we must tackle the root causes—economic and educational inequality.”
This study sheds light on a critical issue: heart disease is not just a medical condition, but also a social issue influenced by income and education. As the gap between rich and poor continues to grow, so does the divide in health outcomes.
Addressing cardiovascular disease will require more than medical treatment—it will demand policies that promote financial stability, equal education opportunities, and better living conditions for all.
If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.
For more health information, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.
The research findings can be found in The Lancet Regional Health – Americas.
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