A large national study reports that people living with congestive heart failure face significantly higher odds of dying when they also experience multiple social disadvantages. Using data from nearly 39,000 adults, researchers found that factors such as unemployment, poverty, food insecurity, lack of health insurance, and unstable housing sharply increased the likelihood of death.
High social disadvantage was common: more than half of adults in the study carried a heavy burden of unfavorable conditions. These individuals were more likely to be members of racial and ethnic minority groups and had greater economic hardship and reduced healthcare access. The charts on pages 5 and 6 show particularly high rates of poverty and food insecurity among groups with the highest social burden.
The risks intensified when social disadvantage coincided with congestive heart failure. People with heart failure and a high burden of social challenges had a 3.47-fold higher risk of dying from any cause and a 5.27-fold higher risk of dying from cardiovascular disease than adults without heart failure and with more favorable social conditions. Survival curves on pages 8 and 9 illustrate a steep drop in survival for these groups.
Younger adults were especially vulnerable. Those under age 65 with heart failure and high social disadvantage had nearly eight times the risk of death. The study also found elevated risks among patients who were unemployed, lacked routine healthcare, or had low educational attainment.
Researchers conclude that addressing both medical and social needs is necessary to reduce preventable deaths and improve outcomes for disadvantaged communities living with heart failure.
See: “Joint association of social determinants of health and congestive heart failure with mortality in U.S. adults” (July 13, 2025)
