"Even in Canada where everyone has medical coverage, a "wealth-health gradient" in mortality rates from heart disease exists among different income groups. Now, results of a new study suggest that older age and more extensive cardiovascular risk factors -- and not sub-par treatment -- explain why poor people have higher mortality rates than affluent people after suffering a heart attack.

Patients with the lowest income were twice as likely as those with the highest to die before scheduled follow-up at 30 days, 1 year, and 2 years, the investigators report in the Annals of Internal Medicine.

"Differences in mortality between poorer and more affluent patients were virtually entirely explained by age and differences in cardiovascular risk profile upon hospital presentation," Dr. Alter said.

"While there were disparities between lower and higher income patients in the type of care that we provided," he added, "those factors were not important players in explaining the survival differences."MORE