MedicalResearch.com Interview with:
Erica Spatz, MD, MHS
Assistant Professor, Section of Cardiovascular Medicine
Center for Outcomes Research and Evaluation
Yale University School of Medicine/Yale-New Haven Hospital
New Haven, CT 06520
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Spatz: Rates of heart attack have declined during the last 15 years. But whether communities of different economic status or in different geographic regions experienced similar declines is unknown, especially as efforts to prevent cardiovascular disease and manage heart attacks may not have been equally successful in communities with different resource capacity.
Our study shows that trends in the incidence of and mortality from heart attack were similar in low, average and high income communities. However, low-income communities had higher hospitalization rates than average and high income communities throughout the 15 year study period. Interestingly mortality rates were similar.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Spatz: Heart attack rates are declining, but low-income communities are constantly playing catch up. Our study shows that heart attack rates in low-income communities lagged behind high income communities by about 4 years. This means that the 2013 heart attack rates for low-income communities were about the same as the 2009 heart attack rates for high-income communities.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Spatz: We are making progress. There have been substantial declines in heart attack incidence and mortality in all communities throughout the US, but still there are gaps.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Spatz: Understanding differences between communities of low and high income is important for targeting research and investments aimed to reduce the burden of heart attack in a community.
For example, in low-income communities, access to healthy foods, green spaces and health care is often limited. There also may be high rates of stress, unemployment, and inadequate social support which may contribute to higher heart attack rates. On the other hand, high income communities may have greater capacity to quickly adopt new models of care delivery and implement effective approaches to preventing heart attack. Illuminating these differences is an important area for future research.
Harlan M. Krumholz, MD, SM et al. Geographic Variation in Trends and Disparities in Acute Myocardial Infarction Hospitalization and Mortality by Income Levels, 1999-2013. JAMA Cardiology, May 2016 DOI: 10.1001/jamacardio.2016.0382
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