Socio-Economic Position and Heart Disease in India

Source: The Hindu

Why in News?

• A study of 65,364 Indians aged 45 years and above, published in the American Journal of Preventive Medicine, found that people with consistently high socio-economic status had higher odds of cardiovascular conditions than those who experienced sustained socio-economic disadvantage.
• Those with sustained socio-economic advantage had 1.8 times the odds of heart failure and 1.7 times the odds of a heart attack compared with the consistently disadvantaged group.

Key Findings of the Study

• The research was conducted by scientists from AIIMS, New Delhi, and Harvard T.H. Chan School of Public Health.
• It examined health outcomes in relation to socio-economic conditions during both childhood and adulthood.
• Four life-course categories were studied:
• Consistently high: High socio-economic position in childhood and adulthood.
• Upward mobility: Low socio-economic position in childhood but high in adulthood.
• Downward mobility: High socio-economic position in childhood but low in adulthood.
• Consistently low: Low socio-economic position in both periods.
• Higher socio-economic position was associated with a greater likelihood of heart failure, heart attack, abnormal heart rhythm and other cardiovascular conditions.

Possible Reasons

• Dietary changes: Greater access to processed foods, refined carbohydrates, sugary beverages and energy-dense diets.
• Physical inactivity: Occupational and domestic lifestyles may become less physically active with economic advancement.
• Epidemiological transition: As India’s socio-economic conditions change, cardiovascular diseases and their risk factors may increasingly affect disadvantaged populations as well.

The findings describe an association; they do not establish that higher income itself directly causes heart disease.

Financial Burden of Heart Disease

• A separate study published in Global Heart highlighted the financial consequences of heart failure among poorer Indian households.
• The average cost of a single hospitalisation for a heart failure patient was reported to be approximately ₹1.19 lakh.
• Hospitalisation can impose substantial financial pressure even after discharge.
• Social health insurance schemes provide financial protection, but families may still bear a significant share of treatment costs.

Significance and Way Forward

• Preventive healthcare: Promote regular screening for blood pressure, diabetes and other cardiovascular risk factors.
• Lifestyle interventions: Encourage balanced diets, regular physical activity and reduced consumption of highly processed foods.
• Equitable healthcare: Improve access to affordable diagnosis, treatment and long-term cardiac care.
• Financial protection: Strengthen health insurance coverage and reduce out-of-pocket expenditure.
• Public health planning: Address cardiovascular risks across socio-economic groups rather than assuming that economic disadvantage alone determines disease burden.