Manténgase sano!

• Posted March 12, 2025

America's Well-To-Do Have Less Heart Disease Risk

Well-to-do and better-educated Americans have far lower rates of heart disease than the rest of the population, a new study says.

The top 20% of high-income, college-educated Americans have less heart disease risk than others, and this gap has widened over the past two decades, researchers say.

“The accumulation of economic and educational advantages appears to drive better health outcomes, rather than any single factor alone,” lead researcher Salma Abdalla, an assistant professor of public health at Washington University in St. Louis, said in a news release.

“Wealth and education cluster among a small, advantaged group, while the majority of Americans face an increased risk of heart disease,” she added.

Compared to wealthier, college-educated people, low-income folks who didn’t graduate from college have a:

• 6.3 times higher risk of heart failure due to clogged arteries.

• 3.2 times increased risk of a stroke.

• 2.3 times increased risk of a heart attack.

• 2.1 times higher risk of angina.

These disparities persisted even after adjusting for heart health factors like blood pressure, cholesterol and Body Mass Index (BMI, an estimate of body fat based on height and weight).

High income and advanced education consistently correlated with better heart health.

Even though the U.S. spends more on health care per person than any other high-income country, overall outcomes continue to lag behind, researchers said.

Life expectancy for the richest 1% of Americans is now 10 years higher than for the poorest 1%, researchers said in background notes.

For this study, researchers analyzed 20 years of data gathered from nearly 50,000 participants in the National Health and Nutrition Examination Survey between 1999 and 2018.

Researchers cited a number of reasons why more well-to-do people have an advantage when it comes to heart health.

Poorer folks might suffer from more stress due to their economic insecurity, while higher-income or better-educated people might have more access to healthy behaviors and activities throughout their lives, researchers said.

The well-to-do also might be better at taking prescribed medicines, have less exposure to environmental toxins and might benefit from stronger support systems, Abdalla said.

Policies to promote broad access to economic opportunity and education are just as important as increased access to health care when it comes to protecting heart health, said senior researcher Dr. Sandro Galea, dean of public health at Washington University.

“The continued widening of health disparities in the U.S. underscores the need for action,” he said in a news release. “If we want to improve public health outcomes, we must address the root causes — economic opportunity, education and access to resources that support long-term health.”

The new study appears in The Lancet Regional Health-Americas.

More information

The American Heart Association has more on preventing heart disease.

SOURCE: Washington University in St. Louis, news release, March 6, 2025