Housing conditions affect cardiovascular health risks

July 15, 2020

DALLAS, July 15, 2020 -- People who are homeless may experience 60-70% higher rates of cardiovascular events, such as heart attacks, strokes and heart failure, compared to the general population, according to a study cited in "The Importance of Housing and Cardiovascular Health and Well-Being," a new Scientific Statement from the American Heart Association published today in the Association's journal Circulation: Cardiovascular Quality and Outcomes.

The statement reviews and summarizes current research about how housing stability, safety, affordability, lack of access to high-quality housing and neighborhood environment affect cardiovascular disease risk. Homelessness is defined by the U.S. Department of Housing and Urban Development as the inability to obtain permanent housing. This includes serial renters who move often, people who temporarily live in a hotel, homeless shelter or with friends, and those living on the street.

Housing is one of several social determinants that impact cardiovascular health. Additional social determinants of health include socioeconomic factors, such as lack of education, unemployment or under-employment, and access to health care, among others.

"The disparities in cardiovascular health among people who are homeless and marginally housed are largely due to psychosocial stressors, unhealthy behaviors used as coping mechanisms and barriers to health care, including lack of insurance and stigmatization among this population," said Mario Sims, Ph.D., M.S., FAHA, chair of the writing group for the scientific statement, chief science officer of the Jackson Heart Study and professor in the department of medicine at the University of Mississippi Medical Center in Jackson, Mississippi.

"Chronic housing insecurity may impact a person's ability to eat properly, get quality sleep, schedule regular medical care or fill prescriptions due to cost. These factors all contribute to inadequate treatment to reduce cardiovascular risk factors such as high blood pressure, high cholesterol and tobacco use, and to the greater likelihood of having a cardiovascular event such as a heart attack or stroke," said Sims.

Among adults who were homeless and housing insecure:Poor housing quality - including structural deterioration, insufficient heating/cooling and exposure to cardiotoxic pollutants such as mold, lead or secondhand smoke - impacts cardiovascular disease risk factors. Studies have found that adults who live in older, public or low-income housing are more likely to have cardiovascular disease. Substandard living conditions affect mental health, which is also associated with heart and blood vessel health in both children and adults. Improving air quality, reducing dampness and living in a comfortable temperature have been shown to lower blood pressure.

Residential segregation by race and ethnicity as well as gentrification have further affected cardiovascular health by making it harder for more individuals to find affordable, high-quality housing. Gentrification is the process of revitalizing a deteriorating neighborhood, with affluent people displacing lower-income residents.

The 2007-2010 foreclosure crisis also had a substantial effect on housing accessibility. Multiple studies found an association between foreclosures and poorer cardiovascular health, with significant differences among races. Hispanics in residential areas at risk for foreclosure had higher rates of high blood pressure and high cholesterol. Foreclosures were also associated with higher rates of heart attacks and strokes among middle-aged Black residents.

"Neighborhood environments are strong predictors of cardiovascular health and well-being," said Sims. "Studies have consistently shown that individuals residing in economically distressed neighborhoods with high poverty and unemployment rates have a higher incidence of cardiovascular risk factors, including obesity, diabetes, hypertension and heart disease, and higher risk of stroke and death from a cardiovascular disease such as heart attacks, strokes, heart failure and others."

Urban design features, such as an area's walkability and accessibility to healthy food options, are associated with body mass index (a way to measure body weight), blood pressure, type 2 diabetes and metabolic syndrome (a cluster of risk factors that include high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels). Research suggests that neighborhood greenness, or vegetation, may also be beneficial for cardiovascular health. Higher levels of greenness are also associated with lower rates of type 2 diabetes, heart attack, coronary artery disease and heart failure.

Providing equitable housing opportunities may improve cardiovascular health, and efforts to reduce health disparities should consider multi-level housing interventions, particularly for under-resourced communities, according to the writing group.
-end-
The scientific statement was written on behalf of the American Heart Association's Council on Epidemiology and Prevention and the Council on Quality of Care and Outcomes Research.

Co-authors and members of the writing committee are Vice-Chair Kiarri N. Kershaw, Ph.D., M.P.H, FAHA; Khadijah Breathett, M.D., M.S., FAHA; Elizabeth A. Jackson, M.D., M.P.H; Lisa M. Lewis, Ph.D., R.N., FAHA; Mahasin S. Mujahid, Ph.D., M.S., FAHA; Shakira F. Suglia, Sc.D., M.S., FAHA. Author disclosures are in the manuscript.

Additional Resources:

Available multimedia is located on the right column of the release link: https://newsroom.heart.org/news/housing-conditions-affect-cardiovascular-health-risks?preview=bd955f0aafdd7f3e66580aa9d565204e

The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.