Healthy wallets make for healthy hearts

Initiatives in low income countries could inspire health care strategies that could be useful in Canada.

Despite increased risks, high income countries have the lowest proportional death rate due to heart disease, likely because of their health care systems.

In a study spanning 17 countries, a group of international researchers, including SFU’s own professor of health sciences, Scott Lear, compiled the medical information of over 100,000 participants over an average period of 4.1 years.

They recently published the results in the New England Journal of Medicine found that, despite higher risk for heart disease in high income countries like Canada, there were fewer proportional deaths.

On the other end of the spectrum, low income countries — such as India and Pakistan — had the highest death rates, despite having the lowest risk.

The Peak sat down with Lear to discuss these findings, as well as some of the challenges he faced while conducting the study.

“There’s different resources across the different countries, and then there’s also different cultural contexts besides just translating the forms,” he explained. Despite receiving higher risk scores when factors including smoking, diabetes, high blood pressure, and family history of heart disease were considered, high income countries were better able to combat heart disease and respond to major cardiovascular events.

Lear explained that people who were injured in low income countries were much less likely to take time off work due to the lack of available financial support. “If they stop working, they don’t get paid,” Lear explained.

Based on the rate of prescriptions in high income countries and overall better access to healthcare, the study suggested that the quality of a healthcare system was a strong influence on the quality of life for participants.

“There’s a lot of gaps and inefficiencies in our healthcare systems,” Lear said. “But when it counts, it does work. And so we should be aware of that.”

The study also exposed researchers to different healthcare strategies across the world. Working with limited resources, low income countries have developed strategies to increase the effectiveness of their health care systems.

“A perfect example is, in a number of countries, they use cell phones for providing healthcare [and] interacting with their patients, but we don’t do that. This is extremely cost efficient,” he said. The study found that personalized reminders helped patients play a more consistent role in their own health; treatments became more effective without a significant increase in staffing.

One of Lear’s areas of research involves using cell phones to support patients who are discharged from the cardiac ward of St. Paul’s hospital. Patients would receive reminders to fill their prescriptions, see their family doctor, and for other tasks relevant to their recovery.

Despite the vast differences in health outcomes, Lear does not discount the important lessons we can learn from low income countries. “These are things that these low income countries are doing, and doing well,” Lear said.