DALLAS, Sept. 6, 2017 -- African-American teens who lived through the Great Recession of 2007-2009 may have higher risk of metabolic syndrome, a common cluster of risk factors for heart disease and diabetes, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.
Researchers studied 328 African-Americans who had experienced the Great Recession of 2007-2009 as 16- and 17-year-olds living in nine rural counties in Georgia with high poverty rates and high rates of death from cardiovascular disease.
From late 2007 to mid-2009, the United States experienced the largest economic recession since the Great Depression of 1929 that lasted through most of the 1930s. Rural African-American communities in the Southeast, already in financially precarious situations, were among the hardest hit, and many have yet to recover the lost jobs, social services and wealth.
The study determined whether these teens developed a cluster of risk factors that raise the risk of heart attack, stroke and diabetes - known as metabolic syndrome by age 25. Metabolic syndrome includes a large waistline, high triglyceride (blood fat) levels, low HDL (the "good cholesterol") levels, high blood pressure and high blood sugar when fasting.
"In previous studies, heart attack and stroke rates have gone up in older adults during economic downturns, particularly when the labor market is bad," said Gregory E. Miller, Ph.D., lead study author and professor of psychology and a faculty fellow at Northwestern University's Institute for Policy Research in Evanston, Illinois. "But few, if any, studies have looked at how these same economic forces affect cardiovascular risk in younger people."
Researchers categorized study participants into three different groups based on their family's economic path from before and after the Great Recession: those whose family incomes were low but stable (Stable Low Income), those whose low family income dropped during the recession (Downward Mobility) and those already living in poverty who became deeply impoverished (Deepening Poverty). A few families experienced upward mobility, but their numbers were too small to draw conclusions.
Then almost a decade later, when the participants were 25-26 years old, they studied rates of metabolic syndrome and found that it differed in the groups. Metabolic syndrome was diagnosed in:
- 10.4 percent of those in the Stable Low-Income group,
- 21.8 percent of those in the Downward Mobility group, and
- 27.5 percent in the Deeping Poverty group.
Researchers said although metabolic syndrome is defined somewhat differently by medical groups, study results remained consistent across three definitions.
The study was not designed to determine why metabolic syndrome was higher in some groups than others, but authors speculate that the more a family's financial situation deteriorated, the less likely the teenagers were to eat healthy and exercise. Authors also believe stress played a role in the findings.
Researchers said they were surprised that the percentage of metabolic syndrome among the Stable Low-Income group was so low. Nationally, they wrote, about 18 percent of 20- to 29-year-olds are estimated to have metabolic syndrome. They noted that even those in the Downward Mobility group were only slightly more likely to have metabolic syndrome than the national average.
"It may be that there were 'protective resources' that these teenagers drew upon that insulated them from the larger economic forces," Miller said. "Strong family relationships, community ties through churches and schools are a real strength that may have offset some of the risk that came with the Great Recession."
He added that pediatricians and primary care providers may have helped. "They may have looked at the broader social situations and said to their patients, 'You've had this great stressor in your life, so now's the time to take stock of our lifestyle and make sure you're eating well and exercising regularly.'"
Study limitations include the fact that participants were not tested for metabolic syndrome before the Great Recession, and study findings may not be generalizable to teenagers living elsewhere who made the transition to adulthood during the same time.
Co-authors are Edith Chen, Ph.D.; Tianyi Yu, Ph.D.; and Gene H. Brody, Ph.D. Author disclosures are on the manuscript.
The National Institute of Child Health and Human Development, the National Heart, Lung, and Blood Institute and the National Institute on Drug Abuse supported the study.
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