A new Northwestern study, published by Circulation: Cardiovascular Quality and Outcomes, found that addressing key social drivers, especially education, could “nearly eliminate” longstanding gaps.
For the study, researchers examined data of 9,104 Hispanic, Black, and white participants from the beginning of their pregnancy, including calculations of each participants’ cardiovascular health scores, which were based on blood pressure, body weight, exercise levels, diet, smoking behavior, and sleep. The research also included participants’ self-reported data on social and environmental factors such as maternal age, education, income, health insurance, mental health, racial discrimination and neighborhood deprivation.
A significant finding: Education attainment, followed by income and health care access, could significantly reduce the gap in maternal heart health.
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According to the study, achieving equity across these social and economic factors— education, income, and access to health care (though primarily education) — could reduce the gap in heart health during pregnancy between Black and white women by 82 percent and “erase it entirely” between Hispanic and white women.
“If racial and ethnic groups achieved the same average years of education, the gaps in heart health between the groups could be substantially reduced,” said Dr. Natalie Cameron, first author of the study and an instructor of general internal medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician, in a statement. “The pathways linking education to heart health are complex and may be related to income, health insurance, access to health care and health-related knowledge.”
The research team underscored the critical need for reform at multiple levels to address the racial and ethnic inequities in cardiovascular health prior to and during pregnancy, calling on researchers, policymakers, and communities to prioritize improved access to healthy foods, health environments for safe exercise and play, and improved access to preventive health care.