Heart disease patients living in poorer areas of B.C. are up to twice as likely to die from chronic diseases than patients living in better-off areas, a University of British Columbia study has found.
The research found coronary-artery disease patients living in lower socioeconomic neighbourhoods are more vulnerable to death from chronic disease, particularly cancer.
“Even in a country with universal healthcare services, a neighbourhood’s socioeconomic status can have a dramatic impact on life expectancy for patients with heart disease,” said study co-author Claire Heslop, a MD/PhD student in UBC's Department of Pathology and Laboratory Medicine.
This trend may reflect the higher overall stress experienced by patients in low socioeconomic areas, the researchers explain. Heslop and UBC Prof. John Hill collaborated with Greg Miller, a researcher in UBC’s Department of Psychology, for the study.
“These findings should prompt a new examination of neighbourhood effects on health, and how they could be improved to better the lives of residents,” Heslop said.
Using mapping data provided by the Human Early Learning Partnership at UBC, researchers studied 485 patients with heart disease across more than 13 years. Death rates from different types of diseases were compared to the patients’ neighbourhood data based on education, median family income and unemployment.
The authors found that patient death rates from chronic diseases other than heart disease were more than twice as high in the lowest socioeconomic area than in the highest. Surprisingly, no difference was found in deaths from heart disease across neighbourhoods.
Researchers have long demonstrated the role neighbourhood and individual socioeconomic trends play in heart disease patient mortality. In B.C., heart disease interventions are performed at centralized hospitals, so patients likely receive equal care regardless of where they live. However, they may suffer from disparities in overall health and health care related to their neighbourhood environment.
This study was funded by the Heart and Stroke Foundation of BC and Yukon. Greg Miller is supported by a McDonald Scholarship Award from the Heart and Stroke Foundation of Canada. Claire Heslop is supported by a Canadian Institutes of Health Research and Providence Health Care Research Institute MD/PhD Studentship Award, and a senior graduate studentship from the Michael Smith Foundation for Health Research.
- Heslop et al. Neighbourhood Socioeconomics Status Predicts Non-Cardiovascular Mortality in Cardiac Patients with Access to Universal Health Care. PLoS ONE, 2009; 4 (1): e4120 DOI: 10.1371/journal.pone.0004120
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