Income and SDOH significantly affect heart health and care. Studies show rising hypertension in low-income adults, coupled with disparities in treatment compared to higher-income groups. Additionally, the influence of income on physician engagement during heart failure hospitalizations indicates potential biases. These findings underscore the need to address implicit biases in healthcare provision while integrating SDOH data into patient care without exacerbating disparities.
Recent studies link income and SDOH to cardiovascular health disparities. They highlight escalating hypertension rates among low-income adults, emphasizing disparities in treatment compared to higher-income groups. Furthermore, income-related biases influence physician engagement during heart failure hospitalizations. Addressing these biases and integrating SDOH data into care plans is crucial for equitable cardiovascular healthcare provision.
Two pivotal studies, one published in the Annals of Internal Medicine and the other in JAMA Network Open, shed light on the correlation between low income and adverse cardiovascular health outcomes, as well as the disparities in healthcare provision among individuals of varying socioeconomic statuses.
In the study featured in the Annals of Internal Medicine, researchers from the Beth Israel Deaconess Medical Center highlighted a concerning trend over a two-decade period. They found that hypertension rates increased more prominently among low-income adults compared to their higher-income counterparts. Analyzing data from the National Health and Nutrition Examination Survey spanning from 1999 to 2020, involving nearly 21,000 middle-aged adults, the researchers noted a significant rise in hypertension incidence among low-income adults, reaching 44.7 percent by 2020 from 37.2 percent in 1999. Strikingly, this escalation wasn’t mirrored in diabetes or obesity rates among the same demographic, though these conditions saw an uptick in high-income adults.
Furthermore, the study revealed a stark disparity in treatment, with low-income adults receiving less attention for hypertension than their high-income counterparts did for diabetes or obesity. Even after adjusting for variables like insurance coverage, healthcare accessibility, and food insecurity, this treatment gap persisted.
Concurrently, the second study, published in JAMA Network Open, examined the engagement of physicians—specifically cardiologists—during inpatient care for heart failure among individuals from varying income brackets. Despite considering nine different SDOH factors, income stood out as the primary determinant influencing physician involvement during hospitalization for heart failure. Shockingly, individuals with lower household incomes were 11 percent less likely to consult a cardiologist during their inpatient stays than those with incomes exceeding $35,000 annually.
The researchers highlighted potential biases among healthcare providers, speculating on implicit bias playing a role. They suggested that the awareness of a patient’s lower income might subconsciously affect the level of care provided, potentially leading to differential treatment strategies or, in some instances, a lack of consideration for certain therapies due to presumed financial constraints or non-adherence concerns.
Acknowledging the importance of addressing these biases, the researchers stressed the necessity of treatment strategies that incorporate social factors while cautioning against systematically withholding therapies based on income disparities, as this could exacerbate existing health inequalities.
Moreover, these findings underscore the importance of integrating SDOH data into electronic health records (EHRs) to facilitate tailored care for individuals facing heightened risks due to social needs. However, the researchers cautioned that the mere identification of SDOH might inadvertently trigger implicit biases within the healthcare system, negatively impacting care provision.
Overall, the impact of income and SDOH on heart health and healthcare provision is evident. Addressing implicit biases in treatment and integrating SDOH data into care plans are essential to mitigate disparities. While acknowledging income-related biases affecting healthcare, efforts should focus on tailored treatment strategies without perpetuating inequalities. Achieving equitable cardiovascular care requires comprehensive approaches that consider social determinants while ensuring fair access to quality healthcare for all socioeconomic groups.
