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It has been found that sustained socioeconomic advantage is associated with higher odds of heart failure and heart attacks than persistent economic disadvantage. What one notices is that sedentary lifestyles, abdominal obesity and unhealthy diets are common traits among the affluent. Higher purchasing power can also be associated with higher cardiovascular risk. However, surprisingly, factors such as access to diagnosis and affordable treatment can influence differences in survival. While affluent patients have greater access to investigations to screen for cardiovascular and other lifestyle-related diseases, as well as to continuous treatment, poorer patients often remain undiagnosed or die prematurely. What is even more surprising is that, according to national survey data from 2019–21, only 8.5 per cent of Indians had the means to test their blood pressure. The conditions in which cardiovascular diseases develop, including air pollution, extreme temperatures and the use of polluting cooking fuels, must also be considered. Sadly, affordable nutritious food, clean air and safe public spaces remain inaccessible to many.
We urgently need policies that integrate reliable primary healthcare with emissions control, clean cooking, healthier food environments and protection from hazardous temperatures. Treating heart disease principally as a consequence of socioeconomic status may lead to failures in healthcare financing and environmental regulation. Therefore, the most important need is an appropriate policy response that offers greater protection to those least able to secure treatment or absorb its costs across income groups.
Iqbal Saikia,
Guwahati