Heart Attack Survivors from Poorer Neighborhoods Get Less Exercise

According to New Study in the American Journal of Preventive Medicine

San Diego, CA, 2 August 2011 – Engaging in physical activity after a heart attack is known to increase the odds of survival. In a study published in the September issue of the American Journal of Preventive Medicine, researchers from the Israel Study Group on First Acute Myocardial Infarction found that myocardial infarction (MI) survivors who lived in low socioeconomic status (SES) neighborhoods engaged in lower levels of leisure-time physical activity (LTPA) compared to survivors from wealthier neighborhoods.

"Neighborhood SES is a powerful predictor of LTPA levels, beyond individual SES and clinical factors,” commented lead investigator Yariv Gerber, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University. “Recommendations for physical activity should be supported by appropriate infrastructure, and the provision of free or low-cost sports facilities in areas of deprivation. Exercise-based rehabilitation should be available to all MI survivors, with special efforts made to encourage participation in patients from deprived neighborhoods. Further research should investigate provision of services for MI survivors in order to reduce inequalities in post-MI health.”

Investigators followed 1,410 MI patients for more than 10 years to determine whether those living in disadvantaged neighborhoods were less likely to engage in LTPA. This association was strongest in the first 5 years following MI. Neighborhood SES was a powerful predictor of LTPA levels, remaining so after extensive adjustment for individual SES and baseline clinical profile. Overall engagement in LTPA was poor for all patients, with 33-37% reporting no activity and 19-27% reporting only irregular activity during follow-up.

Few studies prior to this have examined the relationship between SES and activity patterns in an unhealthy population using longitudinal research with repeated observations over a long period of time. Structured interviews were conducted approximately 1 week after initial hospitalization and subsequently 3–6 months, 1–2 years, 5 years, and 10–13 years after MI in order to collect individual demographic, socioeconomic, and clinical data. LTPA during follow-up was assessed by a self-reported questionnaire.

The article is “Neighborhood Socioeconomic Status and Leisure-Time Physical Activity After Myocardial Infarction” by Yariv Gerber, PhD, Vicki Myers, MSc, Uri Goldbourt, PhD, Yael Benyamini, PhD, and Yaacov Drory, MD (doi: 10.1016/j.ampere.2011.05.016). It appears in the American Journal of Preventive Medicine, Volume 41, Issue 3 (September 2011) published by Elsevier.

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Notes for editors
Full text of the article is available to credentialed journalists upon request; contact eAJPM@ucsd.edu. Journalists wishing to interview the authors may contact Yariv Gerber, PhD, at yarivg@post.tau.ac.il.

About the authors
For the Israel Study Group on First Acute Myocardial Infarction:

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine ( www.ajpm-online.net) is the official journal of  The American College of Preventive Medicine and the  Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine, with an Impact Factor of 4.110, is ranked 10th out of 140 Public, Environmental and Occupational Health titles and 18th out of 151 General & Internal Medicine titles according to the 2010 Journal Citation Reports©published by Thomson Reuters.

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