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A new study from Northwestern University has highlighted the powerful role socioeconomic factors, particularly education, play in maternal heart health disparities among racial and ethnic groups. Published in Circulation: Cardiovascular Quality and Outcomes, the study reveals that addressing these disparities could significantly improve cardiovascular outcomes during pregnancy for Black and Hispanic mothers.
Research has long identified racial and ethnic disparities in maternal heart health, correlating them with an increased risk of preterm birth, preeclampsia, and cardiovascular issues. This new study provides deeper insight into how education, along with other social factors such as income and healthcare access, could nearly eliminate these gaps. If Black and Hispanic women achieved the same average levels of education as white women, the heart health disparity could be reduced by 82 percent for Black women and completely erased for Hispanic women.
The findings suggest that these disparities are driven by social and environmental factors, rather than inherent biological differences at birth.
Dr. Natalie Cameron, the study’s first author and an instructor in Northwestern’s Department of Medicine, said, “If racial and ethnic groups achieved the same average years of education, the gaps in heart health between the groups could be substantially reduced.”
The study analyzed data from 9,104 participants in the Nulliparous Pregnancy Outcomes Study, all of whom self-identified as Hispanic, non-Hispanic Black, or non-Hispanic White. Researchers assessed cardiovascular health scores based on blood pressure, body weight, physical activity, diet, smoking habits, and sleep. They then explored how individual and neighborhood-level factors, such as maternal age, education, income, health insurance, and mental health, contributed to differences in cardiovascular health.
Results showed that these socioeconomic factors fully explained the disparities between Hispanic and white women, and accounted for 82 percent of the disparities between Black and white women. Notably, education level was found to have the largest impact on these cardiovascular health gaps.
The study’s findings echo growing evidence that social and environmental factors are pivotal in shaping health outcomes. Addressing these factors could prevent health disparities before and during pregnancy, according to Dr. Cameron.
“The pathways linking education to heart health are complex, but likely relate to income, health insurance, access to healthcare, and health-related knowledge,” Dr. Cameron explained. She further called for systemic reform to tackle these issues from a public health perspective, recommending improvements to access to healthy food, safe spaces for physical activity, and preventive healthcare, especially before pregnancy.
Cameron emphasizes the importance of early intervention, urging healthcare systems and providers to screen for social determinants of health early in life, well before pregnancy. “Providers can connect patients with social workers and community resources to address these needs,” she said.
Looking ahead, Cameron believes the next steps should involve designing and testing programs that target these social and environmental factors to improve heart health before pregnancy. With this new study, researchers hope to make significant strides toward achieving equity in maternal heart health.
The study was published in Circulation: Cardiovascular Quality and Outcomes (2025). You can read the full study here: Circulation Journal.
