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Income volatility increases risks for CVD, all-cause mortality
Young adults who experienced income volatility had increased risks for CVD and all-cause mortality, according to a study published in Circulation.
“Income volatility presents a growing public health threat, especially when federal programs, which are meant to help absorb unpredictable income changes, are undergoing continuous changes and mostly cuts,” Tali Elfassy, PhD, assistant professor of epidemiology in the department of public health sciences at University of Miami Miller School of Medicine, said in a press release.
Adina Zeki Al Hazzouri, PhD, MSc, assistant professor in the department of public health sciences at University of Miami Miller School of Medicine, and colleagues analyzed data from 3,937 participants (mean age, 30 years; 56% women; 48% black) from the CARDIA study aged 23 to 35 years in 1990. Examinations were performed at baseline then periodically for a total of eight examinations during a 30-year period. Participants were also followed up every 6 months on their vital status and every year regarding certain CVD outcomes.
Primary economic predictors assessed in this study were income volatility between 1990 and 2005 and number of income drops, defined as a decrease in income of 25% or more between visits and less than the average income from 1990 to 2005. Secondary economic predictors of interest were income trajectory and large income changes, defined as decreases or increases greater than $20,000.
Outcomes of interest were CVD and all-cause mortality between 2005 and 2015.
From 2005 to 2015, there were 106 incident CVD deaths and 164 deaths, for an incidence rate of 2.76 per 1,000 patient-years and 3.66 per 1,000 patient-years, respectively.
Compared with participants with low income volatility, those with high income volatility had greater risks for CVD (HR = 2.07; 95% CI, 1.1-3.9) and all-cause mortality (HR = 1.78; 95% CI, 1.03-3.09). Participants with two or more income drops also had greater risks for CVD (HR = 2.54; 95% CI, 1.24-5.19) and all-cause mortality (HR = 1.92; 95% CI, 1.07-3.44) vs. those with no income drops. Similar results were seen in a sensitivity analysis that adjusted for cumulative measures from 1990 to 2015.
“Given the current economic environment of increasing income instability, understanding how income volatility is associated with health has become increasingly important,” Zeki Al Hazzouri and colleagues wrote. “Future studies focused on understanding mechanisms underlying the association between income volatility with CVD and mortality are warranted.” – by Darlene Dobkowski
Disclosures: The study was supported by grants from the NIH, National Institute on Aging and the American Heart Association. The authors report no relevant financial disclosures.