News & Commentary

Income Influences Heart Failure Rate

Back in med school, maybe even in undergraduate days, physicians learned of the inverse relationship between health status and income. The poorer someone is, the more likely he is to develop diabetes, cancer, or even a burst appendix. So it comes as no surprise that a study sponsored by the American Heart Association says that the odds of having heart failure are higher for elderly with low incomes.

Income is more a predictor than even education level. Someone with a college degree who happens to be poor seems to be more susceptible to heart failure than someone with a lower education level who is well off, says Ali Ahmed, MD, MPH, of the University of Alabama at Birmingham School of Medicine.

Ahmed unveiled his study at the American Heart Association’s Scientific Sessions 2011. According to the AHA, Ahmed’s study is the first to link low income with increased risk of heart failure in men and women of Medicare age. Those participants lived in the community, not in any hospital, clinic, or nursing home.

“We observed that community-dwelling Medicare-eligible older Americans with low annual household income of less than $25,000 who represent nearly half of all Medicare beneficiaries were more likely to develop heart failure or die, regardless of education,” says Ahmed.

Addressing this disparity would involve change in national policy, says Ahmed, but medical and pharmacy directors at health insurance plans don’t have to wait for such a major shift. For example, nearly 10 percent of the low-income Medicare beneficiaries do not have any prescription drug coverage, and it can be as high as 17 percent for those not receiving low-income subsidies.

“Providing low cost prescription drugs for low-income Medicare beneficiaries with cardiovascular risk factors such as hypertension or coronary artery disease will likely improve ... care for those conditions, which in turn will likely reduce the risk of incident heart failure and other cardiovascular events or death,” says Ahmed.

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