Cardiovascular disease is a major public health challenge and remains the leading cause of death among people in the United States. While we normally associate heart disease with adults and older people, studies have shown that the foundations of heart health are laid long before people reach adulthood; Childhood, in particular, is a pivotal time when behaviors, environments, and structural factors begin shaping lifelong cardiovascular outcomes. A new study from the University of Minnesota School of Public Health (SPH), led in collaboration with faculty at the University of Minnesota Medical School, adds important evidence to this conversation by examining how early-life sociodemographic factors are associated with cardiovascular health in preadolescence among low-income and racially diverse children.

SPH researchers analyzed data from a randomized controlled trial that enrolled children at ages 2–4 and followed them through ages 7–11. At enrollment, the team documented key sociodemographic factors—including household income, parental education, food security, and participation in public assistance programs. They then tracked these children over time to assess how early-life circumstances were associated with their cardiovascular health in preadolescence. At follow-up, each child’s cardiovascular health was evaluated using the American Heart Association’s Life’s Essential 8 scoring system, which measures diet, physical activity, BMI, cholesterol, glucose, blood pressure, and exposure to tobacco smoke (excluding sleep, which was not measured).

The study, published in the Journal of the American Heart Association, found:

• Children from higher-income households in early childhood were twice as likely to have better cardiovascular health. Young children raised in households with higher incomes (between $35,000 and $64,999) had higher cardiovascular health in preadolescence compared with those in the lowest-income group.  
• Parental education levels mattered. Children whose parents held at least a bachelor’s degree were more than twice as likely to have high cardiovascular health by ages 7–11 compared to those with parents with less than high school education.
• Non-Hispanic white children were more than twice as likely to have high cardiovascular health as Hispanic children..

“The findings highlight that the social and economic conditions children are exposed to early in life can have measurable effects on their health years later,” said Subin Jang, SPH researcher and co-lead author.

“This study underscores the fact that promoting heart health must start early in a person’s life,” said Lenora Goodman, SPH researcher and co-lead author. “To make meaningful progress in improving cardiovascular health across all communities, we need to address the structural and socioeconomic conditions that shape children’s lives.”

Senior author Dr. Junia de Brito, SPH alumna, added that “the study helps fill an important gap by focusing on children from low-income and racially and ethnically diverse households, who have been historically underrepresented in cardiovascular health research.”

The authors recommend that future research should examine how early-life interventions could mitigate disparities in heart health and support healthier cardiovascular trajectories for children from all backgrounds.

Additional co-authors on the article include SPH Professor and Associate Dean for Research Nancy Sherwood, SPH Professor Simone French, and UMN Medical School Associate Professor Alicia Kunin-Batson.