Study Links Marginalized Neighborhoods to Poor Outcomes in AMI Survivors

A recent study published in the *JAMA Network Open* has established a concerning correlation between residing in marginalized neighborhoods and adverse health outcomes among younger survivors of acute myocardial infarction (AMI). Conducted by Dr. Leo E. Akioyamen and colleagues from the University of Toronto, the study analyzed data from 65,464 AMI patients under the age of 65, revealing that those living in marginalized areas faced significantly higher mortality rates and reduced access to healthcare services.

The research, published online on July 2, 2025, highlights that mortality rates for AMI survivors from the least marginalized neighborhoods (Quintile 1) stood at 2.2%, while those from the most marginalized neighborhoods (Quintile 5) reached 5.2% within three years post-discharge. The study indicated that the adjusted hazard ratios for mortality were notably higher for patients from marginalized neighborhoods, ranging from 1.13 (95% CI, 0.95-1.35) in Quintile 2 to 1.52 (95% CI, 1.29-1.80) in Quintile 5.

Moreover, the study documented a substantial disparity in healthcare access, with only 91.6% of patients from the most marginalized neighborhoods visiting primary care physicians compared to 96.1% of those from the least marginalized. Similarly, visits to cardiologists were markedly lower, with 75.7% of patients in Quintile 5 attending compared to 88.0% in Quintile 1. The authors emphasized that universal healthcare systems may not adequately address these inequities, particularly for younger individuals who appear to be more vulnerable to the adverse effects of neighborhood marginalization.

Dr. Akioyamen stated, "Our findings suggest that the challenges posed by living in marginalized neighborhoods extend beyond socio-economic factors, impacting health outcomes significantly even in a universal healthcare setting."

This study underscores the pressing need for targeted interventions to mitigate the health disparities faced by AMI survivors in marginalized neighborhoods. It raises critical questions about the effectiveness of healthcare policies and the necessity of addressing social determinants of health.

The implications of this research extend beyond the immediate healthcare context, highlighting the intersection of socio-economic status and health outcomes. As economic disparities continue to grow, the findings call for a comprehensive approach to healthcare that incorporates social and environmental factors.

In light of these findings, experts suggest that policymakers should prioritize investments in healthcare infrastructure and community resources within marginalized neighborhoods. By enhancing access to care and addressing the underlying social determinants, the health outcomes for vulnerable populations could be significantly improved. As the study indicates, merely providing universal healthcare may not suffice to rectify the disparities faced by marginalized groups.

In conclusion, the study published in the *JAMA Network Open* serves as a critical reminder of the complex interplay between socio-economic factors and health outcomes in younger AMI survivors. The research provides a foundation for further investigation into effective strategies to bridge these gaps and improve the overall health of communities facing systemic challenges.