Economic resurgence not associated with improvement in cardiovascular health

Reviewed by Kate Anderton, B.Sc. (Editor)Sep 8 2019

A new study published in the American Journal of Medicine by the University of Alabama at Birmingham indicates that economic resurgence was not associated with improvement in cardiovascular health among American adults after the great economic recession of 2008-2009. Moreover, cardiovascular health appears to be further deteriorating for American adults, particularly those with high- and low-socioeconomic status.

Nirav Patel, M.D., a resident in the Department of Medicine, explained that an economic downturn can impact population-level health, especially cardiovascular health. The period of 2008-2009 is widely considered as a period of economic recession and was associated with a staggering rise in unemployment and financial losses. There has also been prior evidence to support that economic recession had varying degrees of adverse effects on population health. However, the effect on cardiovascular health had remained previously undefined until this point.

The authors said that in their study they hypothesized that "the macroeconomic fluctuations noted during the economic recession and the subsequent economic recovery would be associated with cardiovascular health of American adults."

Additionally, authors explored whether prevalence of ideal cardiovascular health, as captured by the American Heart Association's Life's Simple 7 metrics, was different among American adults from different socioeconomic strata.

To investigate, Patel and his team examined the National Health and Nutrition Examination Survey from 2007-2016 -; a biannual survey conducted by the Centers for Disease Control and Prevention in American adults age 20 years or older. Patel described the NHANES database as a national treasure that offers a unique opportunity to examine the population-level health trends and also incorporates different socioeconomic strata of the United States.

The researchers found that from 2007-2010 to 2011-2016, American adults showed a decline in mean cardiovascular health score driven by an increasing prevalence of obesity and impaired fasting glucose. Individuals from high- and low-socioeconomic strata showed decreasing prevalence of ideal cardiovascular health. They found that cardiovascular health has continued to decline nationally despite economic recovery.

Obesity and diabetes are resource-intensive chronic diseases. The cornerstones of management of these diseases include nutritious food intake, regular exercise and, for diabetes mellitus, access to increasingly expensive medications like insulin. All of these management strategies, particularly access to medications, can be significantly disrupted in times of financial hardship."

Senior author Pankaj Arora M.D., assistant professor in UAB's Division of Cardiovascular Disease

Arora added that the increase in preexisting cardiovascular health disparities and inequalities as a result of the economic recession is of great concern to clinicians.

"The economic recession and decline in ideal cardiovascular health measures coincided with a reduction in health care spending by the U.S. government," Arora said. "This is particularly worrying to us as cuts in health care funding in an era when ideal cardiovascular health is quantifiably worsening may lead to a potentially endless cycle of poor health outcomes."