We hear a lot about income inequality these days, as we do about our collectively clogged arteries. But it's less often that we're reminded of how one affects the other.
A study in the Canadian Medical Association Journal does just that, tracking the connection between cardiac arrest and income inequality. One of its authors tells Unfair Park that what it says about Dallas is "amazing" -- and not in a good way.
Researchers chose Dallas as one of seven metropolitan areas throughout the United States and Canada. All of the cities participate in a clinical research network called the Resuscitation Outcomes Consortium, and Dallas in particular was able to supply some apparently high-quality data. Not surprisingly, the study found that poor people are more likely to suffer from sudden cardiac arrest -- which in this country has a 5-percent survival rate -- than the affluent.
But that isn't what stunned Dr. Sumeet S. Chugh, the associate director for genomic cardiology at the Cedars-Sinai Heart Institute.
It was this: Dallasites under 65 years old in the lowest income bracket were more than four times as likely to suffer sudden cardiac arrest than those in the highest. The closest runner-up was Portland, Oregon, where the figure was three-and-a-half times as likely.
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It seems odd that, in terms of disparity, the biggest gaps are seen in a younger crowd. "Why is it that the under 65 seem to drive this?" Chugh asks, rhetorically. He can't say for sure, but he can offer up a very well-educated guess.
"Can some of these outcomes be a surrogate for race?" he says. "When you see somebody is poor based on median income, could there be minorities that play a larger role in that scenario?"
Lack of health insurance may also figure in, he added. Eligibility for Medicare doesn't start until 65. Last time we checked, there were more than 50 million uninsured people in the U.S. Cardiac diseases go undiagnosed until it's too late. According to the data, aside from Toronto, Canada came out in much better shape. Could its universal health care system be keeping down heart-attack rates among those younger than 65?
"They spend 10 percent of GDP [gross domestic product] on health care," he points out. "We spend 16. Could that be playing a role?"