Studies have found that social risk factors, such as unemployment, low income, food insecurity, not owning a home and living alone, can all increase the risk of cardiovascular disease and cardiovascular disease mortality, or death from cardiovascular disease.
But few studies have looked at how these social risk factors interact or are affected by behavioral risk factors like smoking or being sedentary and metabolic risk factors like being overweight to increase the risk of cardiovascular disease mortality.
When researchers from Tulane University and the University of Texas analyzed behavioral, metabolic and social risk factors for cardiovascular disease mortality in a large study population, they found that social risk factors particularly contributed to the higher rates of cardiovascular mortality seen among Black participants as compared to white participants.
“After we adjusted for behavioral and metabolic risk factors, the racial differences in cardiovascular disease mortality risk decreased. After we adjusted for the social risk factors, these differences disappeared,” Jiang He, lead author on the study and a professor of epidemiology at Tulane University School of Public Health and Tropical Medicine, told TheDoctor.
Deaths from cardiovascular disease are significantly higher among the Black population than other populations in the U.S.
The study relied on a representative sample of almost 51,000 participants in the National Health and Nutrition Examination Survey. Baseline data were collected over a 20-year period, and the number of deaths from cardiovascular disease were determined using the link between the National Health and Nutrition Examination Survey and the National Death Index.
In addition to the social risk factors outlined above — unemployment, lower income, food insecurity, not owning a home and being unmarried or not living with a partner — the study also considered behavioral and metabolic risk factors.
Behavioral risk factors:
Among the social risk factors considered in the study, loneliness was the reason why being unmarried or not living with a partner was seen as increasing the risk of cardiovascular disease mortality. Those who are married or living with a partner may have more social support and a healthier lifestyle, explained He. Similarly, food insecurity is associated with poor nutrition, so it naturally increases the risk of cardiovascular disease and cardiovascular disease mortality.
Deaths from cardiovascular disease are significantly higher among the Black population than other populations in the U.S., and the researchers hope their findings lead to the development of interventions to reduce these racial differences. They point out, however, that more research is needed to better understand the underlying mechanisms by which social risk factors increase the risk of cardiovascular disease mortality — along with studies to identify vulnerable populations, increase access to food assistance programs and raise awareness about the importance of a healthy diet to reduce cardiovascular disease risk.
The study is published in the Annals of Internal Medicine.