A study published in the American Journal of Cardiology found that a majority of Americans who suffer from heart failure face socioeconomic challenges.

Researchers at UT Southwestern (UTSW) Medical Center found that 8 in 10 ambulatory heart failure patients are negatively impacted by two or more social determinants of health (SDOH). SDOH are nonmedical factors that may influence health outcomes and include reduced access to care, difficult living conditions or economic security, according to a university news release.

“Heart failure is a chronic medical condition that requires close follow-up, long-term medication use and lifestyle change, but adverse SDOH are common barriers to optimal management,” said lead study author Andrew Sumarsono, MD, MPH, assistant professor of internal medicine at UTSW, in the news release.

By 2060, heart failure is projected to be 33% more prevalent than in 2025. Heart attacks will grow by 30%, and strokes will increase by 34%, according to a team of researchers from Harvard and other institutions. Black men remain at the highest risk of dying of cardiovascular disease.

“Our research shows that adverse SDOH are exceedingly common in the heart failure population in the U.S. and that they tend to impact minority groups more significantly,” Sumarsono said. “Developing targeted social interventions to address these adverse SDOH can likely help improve heart failure care on a population level.”


This study is the first to determine the national prevalence of negative SDOH in heart failure patients. Researchers identified 1,906 individuals who reported a history of heart failure and analyzed data by race, ethnicity and characteristics related to SDOH, such as socioeconomic position, access to care and health status.

Researchers found that about 81.4% of heart failure patients surveyed reported negative effects due to two or more SDOH factors. People with lower household incomes reported higher rates of adverse SDOH compared with respondents with higher incomes.

What’s more, food insecurity was twice as prevalent among Black and Latino respondents compared with white patients. Black and Latino patients also reported household crowding at much higher rates, four times greater and 11 times greater, respectively.

“Millions of Americans suffer from heart failure, where the heart muscle is weakened and can’t pump blood properly,” said the study’s first author, Lajjaben Patel, MBBS, a postdoctoral researcher at UTSW.  “When they have access to proper care and support, however, they can successfully manage their condition. The next step in our research is to identify which social determinants have the greatest impact on clinical outcomes and test specific interventions to determine their benefit.”