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Invited Commentary
May 27, 2020

Socioeconomic Status and Heart Health—Time to Tackle the Gradient

Author Affiliations
  • 1Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
JAMA Cardiol. 2020;5(8):908-909. doi:10.1001/jamacardio.2020.1471

Averages are no consolation to those who have been left behind.

Angus Deaton1

One of the most remarkable achievements of the 20th century is the dramatic reduction in death rates from cardiovascular diseases (CVDs) in the United States and several high-income countries. For example, in 1950, the age-adjusted mortality rate per 100 000 population for heart disease was 699 in men and 487 in women in the United States.2 By 2017, these rates had declined to 209 in men and 130 in women, representing more than a 70% reduction.3 Life expectancy at birth for the total US population also improved substantially over that period from 68.2 years in 1950 to 78.6 years in 2017.3 Although invaluable, these summary measures of health are national averages that can mask important differences for population groups defined by age, sex, race/ethnicity, geography, rural or urban residence, neighborhood characteristics, and socioeconomic status (SES).

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