(Reuters Health) – Adolescents from low-income families are more likely than their affluent peers to have risk factors for cardiovascular disease like obesity, inactivity, poor nutrition and tobacco use, a U.S. study suggests.

Income inequality has long been linked to disparities in heart disease risk among adults. The new study examined nationally representative data collected from 1999 to 2014 on 11,557 youth, ages 12 to 19, and found that household finances might also impact heart health for teens.

Low-income adolescents may have a greater risk for heart disease at least partly because they learn health habits from their families, and less affluent adults are more likely to smoke or be obese, said study leader Sandra Jackson of the U.S. Centers for Disease Control and Prevention in Atlanta.

But other factors can make it harder for low-income teens to avoid risk factors for heart disease even when their families support a healthy lifestyle at home.

“For example, poverty makes it harder to afford healthy food like fruits and vegetables, or equipment for organized sports,” Jackson said by email. “And, the neighborhoods of less affluent teens may have more fast food restaurants, fewer grocery stores, fewer parks, or less access to other safe places for physical activity.”

During the study period, the overall proportion of teens with obesity rose from 16 percent to 21 percent, representing an increase of nearly 2 million teens becoming obese, researchers report in Pediatrics. But this was driven entirely by increases in the proportion of low-income and middle-income youth with obesity. Obesity among high-income youth remained stable.

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