Unfavorable social determinants of health and mortality risk by cardiovascular disease status: findings from a National Study of United States Adults

Maqsood, Muhammad Haisum, Nguyen, Ryan, Chang, Ryan, Kundi, Harun, Hagan, Kobina, Butt, Sara, Titus, Anoop, Hyder, Adnan A., Javed, Umair, Al-Kindi, Sadeer, Blaha, Michael J., Mossialos, Elias ORCID: 0000-0001-8664-9297, Nasir, Khurram and Javed, Zulqarnain (2024) Unfavorable social determinants of health and mortality risk by cardiovascular disease status: findings from a National Study of United States Adults. American Heart Journal, 267. 95 - 100. ISSN 0002-8703

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Identification Number: 10.1016/j.ahj.2023.10.006

Abstract

Background: The association between cumulative burden of unfavorable social determinants of health (SDoH) and all-cause mortality has not been assessed by atherosclerotic cardiovascular disease (ASCVD) status on a population level in the United States. Methods: We assessed the association between cumulative social disadvantage and all-cause mortality by ASCVD status in the National Health Interview Survey, linked to the National Death Index. Results: In models adjusted for established clinical risk factors, individuals experiencing the highest level of social disadvantage (SDoH-Q4) had over 1.5 (aHR = 1.55; 95%CI = 1.22, 1.96) and 2-fold (aHR = 2.21; 95% CI = 1.91, 2.56) fold increased risk of mortality relative to those with the most favorable social profile (SDoH-Q1), respectively for adults with and without ASCVD; those experiencing co-occurring ASCVD and high social disadvantage had up to four-fold higher risk of mortality (aHR = 3.81; 95%CI = 3.36, 4.32). Conclusions: These findings emphasize the importance of a healthcare model that prioritizes efforts to identify and address key social and environmental barriers to health and wellbeing, particularly in individuals experiencing the double jeopardy of clinical and social risk.

Item Type:	Article
Official URL:	https://www.sciencedirect.com/journal/american-hea...
Additional Information:	© 2023 Elsevier Inc.
Divisions:	Health Policy
Subjects:	R Medicine > RA Public aspects of medicine
Date Deposited:	04 Jan 2024 16:24
Last Modified:	15 Nov 2024 02:09
URI:	http://eprints.lse.ac.uk/id/eprint/121170

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