Black adults in the U.S. are first hospitalized for heart failure nearly 14 years earlier than white adults, reports a Northwestern Medicine study that analyzed data from more than 42,000 patients across hundreds of hospitals nationwide.

The study, published in The Journal of the American College of Cardiology, also found that Hispanic patients were hospitalized about eight years earlier than white patients, and Asian patients about three years earlier. The paper is titled “Racial and Ethnic Differences in Patient Age at First Hospitalization for Heart Failure.”

On average, white patients were first hospitalized for heart failure at age 73.6, Asian American patients at 70.6, Hispanic patients at 65.4 and Black patients at 60.1.

Using statistical modeling, the Northwestern scientists determined that these differences were associated with social and economic factors, such as whether people had health insurance, if they lived in areas with high unemployment and the level of education in their communities.

Heart failure, a condition in which the heart cannot pump blood effectively, affects over 6 million U.S. adults and is expected to increase significantly in the coming decades.

“These are striking differences, especially for Black patients,” said study first author Dr. Xiaoning Huang, research assistant professor of cardiology at Northwestern University Feinberg School of Medicine.

How the study was conducted

Huang and his colleagues analyzed hospital records from over 42,000 patients across 713 hospitals between 2016 and 2019 using the American Heart Association’s Get With The Guidelines—Heart Failure Registry. The team then compared ages at first hospitalization across racial and ethnic groups and used statistical methods to see how much of the differences could be explained by social and medical factors.

“Our study shows that social risk factors, including insurance status and area-level educational and economic opportunities, played a major role. These factors often limit people’s access to quality health care and shape people’s health long before they develop heart problems,” said Huang.

Closing the gap

Huang stressed that closing these disparities will take more than medical treatment alone.

“Raising awareness is the first step toward advocating for policies that ensure everyone has educational and economic opportunities, healthy food, affordable and high-quality care, and freedom from discrimination, so that neither your ZIP code nor your racial background determines how soon you face serious heart problems,” he said.

At the clinical level, Huang added that health systems need to be aware that heart failure can strike much earlier in certain communities.

“This means starting prevention earlier and screening risk factors sooner,” he said. “We also need social workers to connect patients to resources that address social needs in addition to medical ones.”