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By American Heart Association News
Lack of access to quality housing can be a steady stressor that
increases the risk factors for heart attacks, strokes and other
cardiovascular issues, according to a new report.
"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," Mario Sims, chair of the writing group for the American Heart
Association scientific statement, said in a news release. The work – a
review of the current research on housing's impact on cardiovascular
disease – was published Wednesday in the AHA's journal Circulation: Cardiovascular Quality and Outcomes.
"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, a professor at the University
of Mississippi Medical Center in Jackson. He also serves as chief
science officer of the Jackson Heart Study, the largest research project
to date looking at the causes of cardiovascular diseases in African
Americans.
People are considered homeless, as defined by the
federal government, if they live on the street, are serial renters who
move often, or temporarily live in hotels, homeless shelters or with
friends.
"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," Sims said.
Among adults who were homeless or housing insecure:
- 60% of their cardiovascular disease-related deaths are caused by smoking
- 25% report recent cocaine use, which increases risk of heart attack
- 25% have mental illness, which may contribute to delayed diagnosis and fragmented medical care
- Poor quality of housing, residential segregation and bias contribute to the problem.
Houses
that are deteriorating, that don't heat or cool well or leave residents
exposed to pollutants such as mold, lead or secondhand smoke can impact
cardiovascular disease risk. Improving air quality, reducing dampness
and living in a comfortable temperature have been shown to lower blood
pressure.
Studies have found that adults who live in older public
or low-income housing are more likely to have heart disease.
Substandard living conditions affect mental health, which also has been
linked with heart and blood vessel health in both children and adults.
Residential
segregation by race and ethnicity as well as gentrification – when more
affluent people renovate in neighborhoods and displace lower-income
residents – also can make it harder to find affordable, high-quality
housing.
The scientific statement looked at how the 2007-2010
foreclosure crisis was associated with poorer heart health, and it
highlighted racial disparities. Hispanics in areas at risk for
foreclosure had higher rates of high blood pressure and high
cholesterol. Foreclosures also were 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," Sims said. "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."
The way neighborhoods are designed even has an impact, the report said.
Walkability
and access to healthy food options are tied to body mass index, blood
pressure, Type 2 diabetes and a cluster of heart disease risk factors
called metabolic syndrome.
Research suggests high levels of neighborhood greenness, or vegetation,
are associated with lower rates of Type 2 diabetes, heart attack,
coronary artery disease and heart failure.
