Young survivors of acute myocardial infarction (AMI) are at greater risk of poor outcomes if they live in a marginalized neighborhood, a new study shows. Leo E. Akioyamen, MD, of the University of Toronto Department of Medicine, led the study on this topic, which was published in the Journal of the American Medical Association on Tuesday. Cardiovascular health is linked to neighborhood socioeconomic environments. The places where people grow up can influence lifestyle habits such as smoking, diet and exercise. The investigators in this present study sought to determine how neighborhood differences influence the survival of the growing population of young people (less than 65 years old) who experience AMI. Clinical and administrative databases from Ontario, Canada, were used to create a population-based retrospective cohort. Participants were collected between April 1, 2010, and March 1, 2019, and included those who were under 65 years of age, had their first AMI and received invasive evaluation and survived at least 7 days post-discharge. The primary outcome of this study was a combination of all-cause death, all-cause hospitalization and any AMI after the first AMI. Data were analyzed between May 27, 2022, and March 31, 2025. Neighborhood marginalization was measured by the combination of material deprivation, residential instability and dependency, and proportional hazard regression models quantified the associations between marginalization across 3 years. A total of 65,464 AMI patients were included in the study (median age=56 years, 22.9% female). At 30 days after discharge, higher rates of neighborhood marginalization were associated with higher rates of mortality. At 3-years, the least marginalized neighborhoods (Q1) had a mortality rate of 2.2% and the most marginalized neighborhoods (Q5) had a 5.2% mortality rate. Adjusted hazard ratios (HR) at 3-years were significantly higher in patients in marginalized neighborhoods. These ranged from 1.13 in Q2 (95% confidence interval [CI]: 0.95-1.35) to 1.52 in Q5 (95% CI: 1.29-1.80). Additionally, patients in Q5 had fewer visits with their primary care physicians and cardiologists (91.6%, 75.7%) compared with patients in Q1 (96.1%, 88.0%). Similar results were found in differences in rates of diagnostic testing. Overall, younger patients who had AMI and lived in marginalized areas had higher rates of death and lower rates of clinical care. Source: Akioyamen LE, Sivaswamy A, Haldenby O, et al. Marginalized neighborhoods and health outcomes in younger myocardial infarction survivors. JAMA. 2025 July 2 (Article in press). Image Credit: tonywoodphoto – stock.adobe.com