A major new study shows that the nation’s heart disease burden is moving in the wrong direction for most Americans—and the widening divide is closely tied to income, education, and structural inequities that disproportionately affect Black and Brown communities.
Researchers analyzed 20 years of national health data and found that the top 20% of high-income, college-educated Americans have dramatically lower rates of cardiovascular disease than the remaining 80% of the population. These disparities have expanded over the past two decades, even as cardiovascular disease remains the country’s leading cause of illness and death.
Low-income adults without college degrees faced staggering differences in risk. They had 6.34 times the odds of congestive heart failure, 2.32 times the odds of a heart attack, 2.11 times the odds of angina, and 3.17 times the odds of a stroke compared with wealthier, college-educated peers. These gaps persisted even after adjusting for blood pressure, cholesterol, body mass index, and other health markers.
The study underscores that U.S. health outcomes lag behind other wealthy nations despite record spending. Life expectancy among the richest Americans now exceeds that of the poorest by 10 years, a divide that disproportionately harms racial and ethnic minorities, who are overrepresented in lower-income, less-educated groups.
Salma Abdalla, the study’s lead author, concluded that “the accumulation of economic and educational advantages appears to drive better health outcomes,” while structural barriers raise cardiovascular risks for the majority. Senior author Sandro Galea warned that “the continued widening of health disparities in the U.S. underscores the need for action.”
See: “Study reveals widening heart disease disparities in the US” (March 6, 2025)
