A study in the United States shows that heart failure mortality rates are higher in counties where people face more poverty and social deprivation.

The American Heart Association (AHA) believes that aggressively addressing major clinical risk factors for heart failure could significantly reduce the number of deaths. These clinical factors include hypertension, heart attacks, obesity, diabetes and heart valve disorders.

“Living in a particular county shouldn’t mean you’re more likely to die from heart failure,” says the co-author, Dr. Sadeer G. Al-Kindi, cardiologist at Harrington Cardiac and Vascular Institute of University Hospitals.

“University Hospitals has a history of addressing health care disparities in under-neglected communities and, armed with the information in this study, we can carefully create solutions to better serve these populations.”

One of the limitations of his study, the authors write, was that it was based on the information provided in the death certificates, which may not be accurate in all cases.

In addition, the study was not designed to break down the effects of other recognized risk factors for heart failure mortality, some of which, such as lack of physical activity, obesity, diabetes, and high blood pressure, may also be associated with poverty. However, a recent study showed that these factors together did not account for 57% of geographic variation in heart failure deaths among U.S. counties.

This new study suggests that socioeconomic deprivation may help explain some of this variation.