American Heart Association calls for focus on social factors

The American Heart Association said today that more attention needs to be paid to the social factors that influence heart health, such as race, education, and address.

Those factors may be partly responsible for the increase in rates of cardiovascular disease expected over the coming decades, according to a statement in the journal Circulation.

"What we’re discovering is that this is a very complicated space and there may be a number of variables beyond people's control that have an impact on their health," said Dr. Clyde Yancy, an author of the report.

For example, new research suggests that local pollution levels are tied to the risk of high blood pressure, said Yancy, who is chief of cardiology at the Northwestern University Feinberg School of Medicine in Chicago.

Cardiovascular disease should not differ based on a person's ZIP code, Yancy said.

Every year about 735,000 Americans have heart attacks and about 800,000 have strokes, according to the Centers for Disease Control and Prevention. Heart disease is the leading cause of death for both men and women.

The AHA group writes that deaths from cardiovascular disease have been on a decline since the 1970s thanks to advances in prevention and treatment.

But not all groups have benefited equally across economic, racial and ethnic groups, they write.

"Overall population health cannot improve if parts of the population do not benefit from improvements in prevention and treatment," the group writes.

The statement identifies social and economic status, race, ethnicity, social support, culture and language, access to care and place of residence as being determining factors of health.

Yancy told Reuters Health that the group hopes the new statement will raise awareness about the importance of these factors, create a dialogue that will lead to new discoveries and understanding and lead to better education for healthcare providers.

Beyond better health, he said, paying attention to these social factors is important from an economic standpoint.

"Imagine what happens to our healthcare economy if we begin to realize an increase in what is already a yearly $300 billion price tag for cardiovascular disease," Yancy said.

He and his coauthors point out that the AHA traditionally views cardiovascular disease risk factors as modifiable and non-modifiable, based on physiology, lifestyle and genetics. Now, they must consider social factors as another piece of the puzzle.

Failure to do so "will result in a growing burden of (cardiovascular disease), especially in those with the least means to engage in the healthcare system," the group concludes.