New York Times  [Printer-friendly version]
February 21, 2006


[Rachel's introduction: A new study published in the Journal of the
American Medical Association confirms that people with lower
"socioeconomic status" are twice as likely to die in any given period
of time, even after taking into account age, sex, race and current
smoking habits.]

By Nicholas Bakalar

A new report issued last week adds support to the premise that poor
people are in worse physical condition and have an increased risk for
death compared with those who are better off.

The findings, published last week in The Journal of the American
Medical Association, examined more than 30,000 patients consecutively
referred to the Cleveland Clinic for stress testing. The researchers
assigned a socioeconomic status score to each patient by matching the
home address to economic data in the 2000 census.

Patients exercised on a treadmill while being measured for the maximum
amount of oxygen they consumed during exercise, usually called
functional capacity, and for heart rate recovery, or the amount the
heart rate decreases during the first minute after exercise.

Both slower heart rate recovery and lower functional capacity were
associated with lower socioeconomic status, even after controlling for
age, race, smoking and body mass index.

The subjects were then followed for an average of six and a half
years, through February 2004, to track their survival.

There were 2,174 deaths during the period, and patients in the lowest
quarter of socioeconomic status score were twice as likely to have
died as those in the highest quarter, even though the two groups did
not differ in age, sex, race or current smoking habits.

Dr. Michael S. Lauer, the study's senior author and a professor of
medicine and epidemiology at Case Western Reserve University, said
that poverty itself could be a cause of disease or death.

"Some people think that poverty causes stress to the autonomic nervous
system, the part that regulates blood pressure and heart rate," Dr.
Lauer said. "Stress to the autonomic nervous system can manifest as
hypertension and poor fitness."