Heart failure is a global epidemic affecting some 65 million people all around the world. Yet despite this, and despite the fact that the figure is projected to rise steeply, it’s not given much attention in public discourse. In fact, according to a new study, it’s deemed even less prevalent than potholes.

If the heart becomes too weak or stiff, it may not be able to pump blood around the body properly. This is called heart failure. Heart failure is a common, costly, and potentially fatal condition. For older adults, it’s the leading cause of hospitalization and readmission — as 1 in 5 people with the condition will return to the hospital within 30 days of discharge. In addition, 1-2% of the annual healthcare budget in Europe and the USA is spent on heart failure.

In major segments of the population, heart failure is as dangerous as cancer or dementia. So why don’t we talk about it more?

To see just how popular heart failure is in public discourse, a team of researchers working in the UK analyzed data from the Oxford English Corpus (OEC), a text corpus of 21st-century English-language texts numbering 2 billion words — the largest corpus of its kind. The team also analyzed data from parliamentary debates in the UK from 1945 to 2021 to see how often cancer, dementia, and heart failure are discussed.

In the UK, heart failure and dementia have comparable incidences, affecting around 200,000 and 209,000 people respectively, and killing around 64,000 and 66,400 respectively. The number of both new cases and fatal cases of cancer is in the range of twice as high as those conditions. But cancer receives substantially more attention.

“In the OEC, the term ‘heart failure’ occurs 4.26 times per million words (pmw), ‘dementia’ occurs 3.68 times pmw and ‘cancer’ occurs 81.96 times pmw, the researchers write in the peer-reviewed study. “Cancer is talked about 19 times more often than heart failure and 22 times more often than dementia. These are disproportionately high in relation to actual incidence: annual cancer incidence is 1.8 times that of the other conditions; annual cancer mortality is two times that caused by coronary heart disease (including HF) or dementia.”

In parliamentary debates, where presumably healthy policy is being devised, the discrepancy was even greater: while dementia has received some attention starting in the early 2000s, heart failure was all but completely ignored.

But it gets even more dubious: not only is heart failure less discussed in the British parliament than dementia or other comparable conditions, but it’s even less discussed than potholes — much less discussed.

Over the past few years, potholes have taken up much more time parliament time than heart failure, particularly over the past 10 years, when potholes peaked in terms of frequency at:

1. 10.24 times pmw in 2018 (about 37 times more often than ‘heart failure’ at 0.28 times pmw).
2. 6.61 times pmw in 2014 (about 16 times more often than ‘heart failure’ at 0.42 times pmw).
3. 5.74 times pmw in 2010 (about 18 times more often than ‘heart failure’ at 0.32 times pmw).

Occasionally, before 2010, ‘heart failure’ became slightly more prominent than potholes, but in general, far less attention was granted to heart failure. Sure, potholes can cause a lot of frustration and annoyance, and in extreme cases they can even pose threats to our health, but they’re arguably less important than something like heart failure.

“If we take frequency of mentions as an indicator of importance, the topic of [heart failure] has been much less important in UK parliamentary debates in recent years than even potholes in roads and pavements,” the researchers comment.

“It is crucial that all stakeholders involved in [heart failure] redouble their efforts to spread awareness regarding the seriousness of the condition and the pressing need to significantly improve investment in prevention, early diagnosis, and better management,” they conclude.

Even when heart failure is discussed, the debate seems to be technical and formulaic, lacking the personal narratives that can be so convincing. Language around heart failure is not as empowering or motivated as that around cancer, the researchers call out.

“Our study has elucidated that HF is relatively underdiscussed in comparison to other conditions such as cancer and dementia, both in societal discourse as well as in UK parliamentary debates. Despite comparable morbidity and mortality, discussions regarding people with HF are less person-centered and empowering in comparison to the language used to describe people with cancer,” the study notes.

It could be useful to carry out a similar study on discourse in different countries, and include a wider range of cardiovascular terms (such as “heart attack” or “cardiovascular disease”), the researchers also say. It could be possible that cardiovascular diseases could be generally under-discussed, despite causing a huge health toll.

The study was published in the journal Open Heart.