Risk of heart attacks higher for poor Canadian neighbourhoods

Your income and your address are two key factors that play a role in the health of your heart researchers learned. Researchers learned that people who live in poor neighbourhoods are most likely to suffer a heart attack.

The latest survey of Canada's health care system and the overall health of Canadians has added another nail to the link between income levels and general health with the finding that people from poorer neighbourhoods are most likely to experience heart attacks. Researchers from the Canadian Institute for Health Information (CIHI) attributed that difference to lifestyle habits of poorer Canadians. Released on May 27, Eugene Wen, CIHI's Manager of Health Indicators said in a press release

"While a person’s socio-economic status affects the risk of having a heart attack, it appears that where you live in Canada makes a bigger difference. Regions with higher heart attack rates also tend to have higher rates of hypertension, diabetes, smoking and other cardiac risk factors.”

Wen was referring to the finding that there are pockets of Canada that have a higher incidence of heart attacks than other geographic areas. For example, people in Newfoundland tend to have more heart attacks than do people who live in British Columbia. The researchers found

"Overall, the rate of heart attacks in the least affluent neighbourhoods was 37% higher than the rate in the most affluent ones."

However, care for most patients once hospitalized was equitable, the researchers found. Indra Pulcins, Director of Indicators and Performance Measurement at CIHI said

“It is reassuring to see that in our universal system, the quality of care is similar for all heart attack patients. However, important gaps in heart health still exist between socio-economic groups, as well as between geographic regions in Canada. Addressing these gaps could help improve the health of the population.”

But the CIHI report failed to make any recommendations to address the differences between rich and poor, saying instead that more studies need to be undertaken to understand and address the disparities. CIHI theorized the disparties are the result of "... the circumstances and the environments in which people grow, live, work and age, and the health systems put in place to promote health and deal with illness." The Heart and Stroke Foundation of Canada said cardiovascular diseases in Canada have been declining since 1956. The CIHI study also found a geographic difference in the incidence of hysterectomies for Canadian women, with rural areas more likely to remove a woman's reproductive organs than urban. Overall, there are less and less hysterectomies being performed. The gap between Canada's richest and poorest has been widening for the past generation warns Trish Hennessy, Director of the Growing Gap Project. According to Statistics Canada,"... the top 20% of families held 75% of total household wealth in 2005." The Organization of Economic Cooperation and Development (OECD) warned Canada in 2008 "... the income gap between Canada’s rich and poor is growing faster than most of the other 30 developed nations in the world, and that our governments need to stop that trend," reported the Canadian Center for Policy Alternatives. Earlier this month, two York University researchers research a study called Social Determinants of Health: the Canadian Facts. Authors Mikkonen and Raphael said

"...we have now accumulated indisputable evidence that social injustice is killing people on a grand scale.”

The authors go on to say

"... in all countries – and that includes Canada – health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.

... The truth is that Canada – the ninth richest country in the world – is so wealthy that it manages to mask the reality of poverty, social exclusion and discrimination, the erosion of employment quality, its adverse mental health outcomes, and youth suicides. While one of the world’s biggest spenders in health care, we have one of the worst records in providing an effective social safety net."

Those living in poverty are at a greater risk of becoming homeless, participate in commiting crimes or become addicted to drugs. Obesity, chronic disease and suicide rates are also greater for the poor. The recession has increased the levels of poverty in Canada. Citizens for Public Justice said nearly 1 million more people were reduced to poverty as a result of the recession. Another report, Mending Canada’s Frayed Social Safety Net: The role of municipal government was released in March. That report said London Ontario had the largest disparity between rich and poor in the whole of Canada, reported the Gazette.