SIOUX FALLS, S.D. (KELO) — Where a person lives and how much money they make are contributing factors to whether or not they will have heart disease, according to multiple research studies.
The South Dakota Department of Health said 29,000 residents are affected by heart disease or heart attacks each year.
A state collaborative found that as income levels and education levels decreased, the frequency of heart attacks and heart disease increased.
“Heart disease and stroke disproportionately impact certain South Dakota communities, including American Indians, people living in rural communities, and people with lower incomes,” the Cardiovascular Collaborative Strategic Plan for 2022-2026 from the South Dakota Department of Health said.
A study released in 2020 by the University of California San Francisco said that hypertension, diabetes and smoking account for less than half of the excess burden of heart attacks and strokes among poorer Americans. The study showed that 60% to 70% of excess heart disease can be attributed to poverty.
South Dakota Cardiovascular Collaborative identified Native Americans, people living in rural areas, and people with lower incomes as priority populations.
Why would poverty be a factor?
Research says that while factors such as smoking and obesity are risk factors for heart disease, the factor of low income and poverty cannot be overlooked.
People with lower incomes may not be able to afford fresh fruits and vegetables. Also, access to these foods may be limited because there are fewer supermarkets.
Obesity and poor diet have been linked to heart issues so a diet with limited fruits and vegetables contributes to both.
Research has also linked the stress of living in poverty or with a low income to heart disease. Stress can increase inflammation in the body including creating chronic inflammation that affects the heart and arteries.
Poverty or low income can also make it more difficult to exercise regularly. Also, access to health care can be limited by income and neighborhood.
Why would living in a rural area make someone more vulnerable to heart disease?
The South Dakota cardiovascular collaborative said the state DOH designated about 80% of the state in a health professional shortage area because of geographic and low-income disparities.
The risk factors in a rural area may be similar to that of poverty or low income.
Access to health care can be more difficult in rural areas. If people have limited access to health care they may not be taking healthy care of themselves. Rural areas may also have less access to supermarkets with fresh food options.
The National Institute of Health reported in January that an observational study revealed that adults living in rural areas have a 19% higher risk of developing heart failure compared to their urban counterparts.
Although cities such as Sioux Falls and Rapid City are growing, most of South Dakota is considered rural. Thirty of the state’s 66 counties are designated as rural while 34 are considered frontier, according to the U.S Department of Health and Human Services.
The DOH collaborative said that in South Dakota, the low-income and rural area factors are illustrated in the Native American population.
Cardiovascular disease is the leading cause of death “among American Indians and Alaska Natives,” according to the Centers for Disease Control.
South Dakota’s rate of heart disease for the American Indian population is 259.7 per 100,000 individuals for American Indians compared to 149.9 for whites, according to KFF, a health organization.
“Native Americans in particular may be impacted by a number of intersectional
factors that can influence cardiovascular health including low socioeconomic status, diabetes,
and culturally exploitative marketing tactics by tobacco industry,” the South Dakota DOH cardiovascular collaborative said.
Smoking is a risk factor for heart disease and the DOH collaboratives said tobacco is involved in 17 ceremonial, religious and medicinal roles in some tribes’ cultures.
What’s the overall risk in South Dakota?
Heart disease has been the leading cause of death for South Dakotans over the past 10 years, according to the DOH.
The provisional South Dakota mortality rate is through November of 2022. It’s the most recent available. The DOH said the data reflects deaths reported to the department as of Jan. 28.
From January through November 2022, 1,653 residents died from heart disease. Cancer was the second leading cause of death with 1,521. COVID-19 was third with 425 deaths.
Although heart disease is the leading cause of death in South Dakota, the state had the 22nd lowest death rate from cardiovascular disease in the country in 2017, according to the American Heart Association. The CDC said that in 2020, South Dakota ranked 20th with a death rate of 1,820 per 100,000 individuals.
The DOH collaborative said, based on 2020 data, that males (6%0 were more likely than females (3%) to have heart disease and experience a heart attack.
Factors that increase the risk are 54% did not meet physical activity guidelines in 2019, 33% of the state’s residents are obese and 18% smoke cigarettes.