Recent research of significant importance published in the Journal of the American Heart Association, an accessible, peer-reviewed journal, suggests that individuals residing in areas plagued by social and environmental challenges could face a twofold increase in the risk of heart disease and stroke. The study, a beacon of knowledge, highlights a broad range of ecological adversities such as air and water pollution, potentially harmful or toxic locations, scarcity of recreational parks, and proximity to busy roads, railways, or airports. Social vulnerabilities were identified based on factors including racial and ethnic minority status, socio-economic aspects like income, education, employment levels, housing situations, and the availability of internet and healthcare.
Sarju Ganatra, M.D., the study’s senior author, emphasised the research’s novelty in considering both social and environmental factors simultaneously, aiming to understand their intricate relationship. Dr Ganatra, who serves as a cardiologist and vice-chair in the department of medicine for research and is the director of the Cardio-Oncology Program and South Asian Cardio-Metabolic Program at Lahey Hospital and Medical Center in Burlington, Massachusetts, detailed the comprehensive nature of this analysis.
The study assessed environmental disadvantages across U.S. census tracts using the Environmental Justice Index, which incorporates data from the U.S. Census Bureau, the Environmental Protection Agency, the Mine Safety and Health Administration, and the Centers for Disease Control and Prevention. The findings were revealing: individuals in the most environmentally vulnerable areas experienced a 1.6-fold increase in the occurrence of blocked arteries and more than double the rate of strokes compared to those in less vulnerable areas. Further, these areas also reported significantly higher rates of cardiovascular risk factors, including Type 2 diabetes, chronic kidney disease, high blood pressure, and obesity.
The study also shed light on the demographic distribution of environmental burdens, noting that a significant portion of the U.S. population, particularly among younger adults and Black and Hispanic communities, resides in areas with high ecological risks. Dr. Ganatra expressed surprise at the strong correlation between social and environmental factors and their combined impact on health outcomes, even after adjusting for socio-economic variables.
Addressing the urgent consequences of social and environmental disadvantages, the researchers strongly advocate for a comprehensive strategy involving pollution reduction, poverty alleviation, urban renewal, education improvement, job creation, affordable housing, and ensuring universal healthcare access. The goal is to enable healthcare providers to better educate patients about the environmental risks they face, thereby empowering individuals to minimise their exposure to health hazards.
In line with these findings, the American Heart Association’s policy statement in March 2024 calls for integrated public policies to adapt cities for heart-healthy, sustainable living. It emphasises the importance of urban provisioning systems, including energy, mobility, housing, green infrastructure, water, and waste management, in improving the cardiovascular and metabolic health of urban populations.
The study employed the 2022 Environmental Justice Index, a socio-environmental justice index, and an environmental burden module to evaluate the cumulative impact of ecological injustice across over 71,000 U.S. census tracts. By comparing age-adjusted rate ratios of blocked arteries, strokes, and various health measures from the Prevention Population-Level Analysis and Community Estimates data, the research provides a detailed analysis of the pervasive influence of socio-environmental factors on health.
More information: Sumanth Khadke et al, Association of Environmental Injustice and Cardiovascular Diseases and Risk Factors in the United States, Journal of the American Heart Association. DOI: 10.1161/JAHA.123.033428
Journal information: Journal of the American Heart Association Provided by American Heart Association
