There's an economic explanation for why so many more Southerners die of heart disease


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South Carolina State Sen. Weldon Waites, spreads mustard glaze on the BBQ.

Southerners struggle with heart disease at a much higher rate than the rest of the US, and according to new research it may have a lot to do with their wealth.


Since the 1950s, the American South has experienced a disproportionate influx of wealth, and a new study from Richard H. Steckel and Garrett Senney at the Ohio State University links that increase to the higher rates of heart-disease deaths.

Their findings are based off the idea that health conditions are transferred intergenerationally in utero via the placenta. This transference via pregnancy actually reverberates over successive generations.

Now that may seem like it has nothing to do with the wealth increase, but over time the average Southerner had developed health traits based on the relatively poorer, more agrarian lifestyle of the region.

In the post-World War II change, the wealth that flowed into the Southern states seriously shifted the economic and cultural landscape of the region. This changed diets and, well, here's Steckel and Senney:


"While it is unsurprising that transitioning from a good to a poor nutritional state has negative health consequences, recent literature identifies negative effects that follow a transition from a poor to a good nutritional state. Research suggests that individuals with organs (e.g., kidneys and liver) optimized in utero for survival in lean conditions are more likely to suffer from [cardiovascular disease] if they consume a rich diet later in life."

These risks were especially true for those that were born just before or during this socioeconomic shift, which the researchers say started around from 1950.

"This suggests that the penalties of unbalanced physical growth increase when the developing body has less ability to adapt to a new environment," they wrote in the study. "Individuals aged 75-84 in 2010 were born from 1926-1935 and were young adults with fixed biological structures, when dramatic social and economic change transformed the South after 1950."

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Steckel and Senney/NBER

There are a number of factors that contributed to the changes - increased purchases of food, more sedentary jobs, increase in the number of mothers working outside of the home, and more. These changes plus genetics from mothers added up to worse heart disease for years.

The researchers do show, however, that this could also offer a positive new prevention step.


"Heart attacks and strokes often appear after cardiovascular disease is well advanced, but this problem could be lessened by knowledge of proclivity based on socioeconomic information that many patients could readily provide, such as occupations of the parents and grandparents and their counties of birth and residence in adolescence," they wrote.

The idea being, if those Southerners had farmers or laborers for grandparents, it would behoove them to adjust to a healthier diet early, as their risks are higher.

The researchers also acknowledged inherent cultural factors that could contribute. But it's just as much genetics as it is biscuits contributing to the high rates of heart-disease deaths in the South.