Socioeconomic and Psychosocial Vulnerabilities in Low-Income Heart Failure Patients in Japan: A Single-Center Cohort Study

Abstract

Low-income status is an important social determinant of health in patients with heart failure （HF）. In this retrospective study of 88 patients hospitalized for acute HF, 26.1% were classified as low-income based on public assistance or resident tax exemption. Low-income patients exhibited poorer physical performance, lower grip strength, and reduced cognitive function, as well as a higher prevalence of social isolation, particularly perceived loneliness. Low-income status was independently associated with social isolation. Mortality and HF readmission rates at 6 and 12 months did not differ between income groups. These findings indicate that low-income HF patients face greater physical, cognitive, and psychosocial vulnerabilities despite similar shortterm clinical outcomes, highlighting the potential value of multidisciplinary approaches focusing on social support and functional maintenance.