Posted on Nov 14, 2019, 6 p.m.
A recent study suggests that millions of Americans do not know the symptoms of heart attack or how best to respond to them, and certain socioeconomic groups are at particular risk.
805,000 Americans have a heart attack every year, and 15% die from it because the opportunity for early intervention is missed; in fact, early intervention is so critical healthcare officials have spent decades trying to improve public health knowledge of the symptoms and appropriate emergency response for a heart attack.
To examine if these efforts were being effective a study was conducted involving over 25,000 American adults using data from the 2017 National Health Interview Survey which will be presented at the American Heart Association’s Scientific Sessions. Participants responded yes or no to whether the following were symptoms of a heart attack: shortness of breath; pain or discomfort in the arms/shoulder; feeling faint/weak/lightheaded; chest pain or discomfort; and pain in the neck/jaw/back. Results show that 6% of the respondents were not aware of any of the symptoms, and 53% were aware of all 5 symptoms.
"It is most striking that we found nearly 6% of individuals – which represents over 13.5 million adults in the U.S. – were not aware of a single symptom of a heart attack," said Shiwani Mahajan, the study's lead author. "You would expect it to be fairly common knowledge that chest pain is a symptom, but millions of individuals were not aware," said Mahajan, a postdoctoral associate at Yale School of Medicine's Center for Outcomes Research & Evaluation.
Men, Hispanics, African Americans, those born outside of America, and those with high school education or lower were found to be significantly more likely not to be aware of any symptoms of a heart attack.
“Some of these subgroups, especially those not born in the U.S., are hard to reach because of language barriers," Mahajan said. "These are the subgroups that are most in need of, and may benefit the most from, targeted public health awareness initiatives."
Participants were also asked whether the best response to a possible heart attack would be calling emergency medical service or other; 4.5% chose other.
"It would be interesting to see why they are hesitant, and what prevents these individuals from accessing emergency medical care," Mahajan said. "Are they worried they may be wrong, and they're afraid of embarrassment? Or is it because of cost-related barriers to healthcare access? Having timely access to emergency medical care can be lifesaving, for which both prompt recognition of symptoms and appropriate rapid emergency response are crucial."
Cost concerns could influence why many low income populations have reluctance to immediately call emergency services, according to Tarryn Terulien, "I wasn't too surprised by that finding," said Tertulien, who wasn't involved in the study. "If they're thinking about what the ambulance costs and the insurance bill, they may be less inclined to call 911."
"The study is very much a testament to the need for targeted health literacy interventions so we can close these gaps," Tertulien said. "We may have to increase awareness one-on-one, in addition to public awareness campaigns, which might not reach the people who are the most impacted."
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