The following is a summary of “When the economy falters, hearts suffer: Economic recessions as a social determinant of health in cardiovascular emergencies,” published in the February 2024 issue of Emergency Medicine by Won, et al.

While the connections between cardiovascular disease (CVD), stress, and financial strain are extensively researched, the impact of recessionary periods and broader macroeconomic conditions on disease-specific CVD emergency department (ED) visits remains less understood. For a retrospective observational study, researchers sought to investigate the correlation between macroeconomic trends and CVD-related ED visits.

Data from the National Hospital Ambulatory Care Survey (NHAMCS), Federal Reserve Economic Database (FRED), National Bureau of Economic Research (NBER), and CVD groupings from National Vital Statistics (NVS) and Center for Medicare and Medicaid Services (CMS) spanning from 1999 to 2020 were utilized to analyze ED visits in conjunction with macroeconomic indicators and NBER-defined recessions and expansions.

CVD-related ED visits increased by 79.7% from 1999 to 2020, surpassing the growth rate of total ED visits (27.8%, P < 0.001). Approximately 213.2 million CVD ED visits were estimated, with 22.9 million occurring during economic recessions. A secondary analysis incorporating six months before and after each recession (“broadened recession”) was conducted, totaling 50.0 million visits. Significantly higher proportions of CVD ED visits associated with heart failure (HF) and acute ischemic heart diseases (IHD) were observed during recessionary periods, both directly and with a 6-month lead and lag (P < 0.05). Similarly, the proportion of visits related to aortic aneurysm and dissection (AAA) and atherosclerosis (ASVD) was notably higher (P = 0.024) during recession periods with a 6-month lead and lag. After adjusting for common demographic factors, economic indicators of recession, such as the Consumer Price Index (CPI), federal funds rate, and real disposable income, were significantly linked to increased CVD ED visits.

The study underscored the significant impact of macroeconomic trends on the composition of CVD-related ED visits, highlighting the role of economic conditions as a crucial but often overlooked determinant of health.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723006496