Researchers at Tufts University found that most adults in the United States have impairments in five components of heart and metabolic health, with clear racial disparities.
Scientists have uncovered a devastating health crisis that requires urgent action: Less than 7% of the US adult population is healthy for heart disease. That’s according to a study led by a team from Tufts University’s Friedman School of Nutrition Science and Policy in a groundbreaking perspective on cardiovascular health trends and disparities to be published in the July 12 issue of the journal. Journal of the American College of Cardiology. The research team also included scientists from Tufts Medical Center.
These numbers are staggering. It’s so hard that in the United States, one of the richest countries in the world, less than 1 in 15 adults has optimal heart health. -” Megan O’Hearn
In the study, US researchers assessed by five components of health: blood pressure levels, blood cholesterol, blood sugar, obesity (overweight and obesity), and the presence or absence of cardiovascular disease (heart attack, stroke, etc.) Only 6.8% of adults in the United States had optimal levels for all five components as of 2017-2018. Among these five components, trends between 1999 and 2018 worsened significantly with respect to blood sugar and obesity. In 1999, 1 in 3 adults had ideal levels of obesity (not overweight or obese), but by 2018, that number had dropped to 1 in 4. Less than 40% of adults were free of these conditions in 2018.
These numbers are staggering. It is deeply problematic that in the United States, one of the richest countries in the world, fewer than 1 in 15 adults with optimal heart disease have heart disease, said Megan O’Hearn, a doctoral student at Friedman College and lead author of the study. “We need a complete overhaul of our healthcare system, our food system and our built environment, because this is a crisis for everyone, not just one segment of the population.”
The study looked at a nationwide representative sample of nearly 55,000 people aged 20 or older from 1999 to 2018 from the 10 most recent cycles of the National Health and Nutrition Examination Survey. Researchers focused on optimal, intermediate, and impaired levels of cardiovascular health and its components, rather than simply the presence or absence of disease. “We need to change the conversation, because disease isn’t the only problem,” O’Hearn said. “We don’t just want to be free from disease. We want to achieve optimal health and well-being.”
The team also identified significant health disparities between people of different sexes, ages, races, ethnicities and education levels. For example, less educated adults were half as likely to have optimal cardiovascular health as adults with higher education, and Mexican Americans had one-third optimal levels versus non-Hispanic white adults. Additionally, between 1999 and 2018, while the percentage of adults with good cardiovascular health increased modestly among non-Hispanic white Americans, it decreased for Mexican Americans, other Hispanics, and non-Hispanic blacks. and adults of other races.
“We don’t just want to be free from disease. We want to achieve optimal health and well-being.” – Megan O’Hearn
“This is really problematic. Social determinants of health such as food and nutrition security, social and societal context, economic stability, and structural racism place individuals of different levels of education, races and ethnicities at increased risk of health problems,” said Dariush Mozaffarian, Dean of Friedman. School and senior author. This highlights other important work underway at the Friedman School and Tufts University to better understand and address the underlying causes of malnutrition and health disparities in the United States and around the world.”
The study also assessed “average” levels of health – not ideal but not yet bad – including conditions such as pre-diabetes, high blood pressure, and weight gain. “A significant portion of the population is at a critical inflection point,” O’Hearn said. “Identifying these individuals and addressing their health conditions and lifestyle early on is critical to reducing the growing health care burden and health disparities.”
The consequences of poor health among adults in the United States go beyond personal health. “Its implications are enormous for national healthcare spending and the financial health of the entire economy,” O’Hearn said. These conditions are largely preventable. We have public and clinical health interventions and policies in place to be able to address these problems.”
O’Hearn said researchers at the Friedman School are actively working on many of these solutions, including interventions Food is Medicine (using good nutrition to help prevent and treat disease); Incentives and subsidies to make healthy food affordable; consumer education about a healthy diet; and private sector commitment to drive a healthier and more equitable diet. “There are a lot of different avenues in which this can be done,” O’Hearn said. “We need a multi-sectoral approach, and we need the political will and desire to do that.”
“This is a health crisis that we’ve been having for a while,” O’Hearn said. “Now there is a growing economic, social and moral imperative to give this problem far more attention than it has been getting.”
Reference: “Trends and Disparities in Cardiovascular Health among US Adults, 1999-2018” by Megan O’Hearn MS, Brianna N. Lauren MS, John B.Wong MD, David D. Kim PhD and Dariush MozaffarianMD, DrPH, July 4 2022 and Journal of the American College of Cardiology.
DOI: 10.1016 / j.jacc.2022.04.046
Funding: National Institutes of Health/National Heart, Lung, and Blood Institute
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