Heart failure & cardiomyopathies

Socioeconomic Correlates of Incident Heart Failure and Consequent Mortality: The All of Us Program

JACC Heart FailPublished Prospective cohort study

Authors' conclusion

Lower income, education, and high neighborhood deprivation independently associate with incident HF, whereas only income was associated with mortality. Higher education was less protective in non-White participants and individuals residing in deprived neighborhoods.

Study context

Population
Adults in the All of Us Research Program sharing EHRs: free of heart failure (HF) (incident HF) and with prevalent HF (mortality)280,431 HF-free
Exposure
Income, education and Area Deprivation Index (ADI) categories vs highest-SES reference
Outcome
Incident HF (adults without HF); all-cause mortality (adults with HF)
Follow-up
41 ± 23 months

Main finding

As reported in the abstract

Incident HF
Hazard ratio (95% CI)
$100,000 to <$200,000vs ≥$200,000
1.29(1.12–1.48)
$50,000 to <$100,000vs ≥$200,000
1.82(1.60–2.09)
$25,000 to <$50,000vs ≥$200,000
2.24(1.95–2.57)
<$25,000vs ≥$200,000
3.02(2.63–3.47)
Some collegevs College graduates
1.37(1.28–1.46)
General Educational Developmentvs College graduates
1.46(1.36–1.58)
Less than high schoolvs College graduates
1.40(1.26–1.55)
Middle ADI tertilevs Least deprived ADI tertile
1.21(1.14–1.29)
Most deprived ADI tertilevs Least deprived ADI tertile
1.18(1.11–1.26)
Participants developing HF
6,783 of 280,431

Observational data: associations, not effects.

Further findings

All-cause mortality in prevalent HF

Each $10,000 income increase: lower all-cause mortality
3%

Incident HF, education benefit by race and ADI (subgroup)

Non-White participants and residents of most deprived ADI tertiles had less benefit from higher education

Original publication

Socioeconomic Correlates of Incident Heart Failure and Consequent Mortality: The All of Us Program. JACC Heart Fail. Published 25 March 2026. doi:10.1016/j.jchf.2026.103012

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