1. In this cohort study, individual and community-level social determinants of health (SDOH) were associated with increased risk of atherosclerotic cardiovascular disease (ASCVD) events.
Evidence evaluation level: 1 (great)
Social determinants of health (SDOH) are a number of conditions that affect people's health, function, and quality of life. Cardiovascular health is often influenced by the individual's SDOH as well as the community's SDOH. Atherosclerotic cardiovascular disease (ASCVD) has been previously studied and found to be associated with both individual and community-level socio-economic status. However, the quantitative risks associated with insufficient her SDOH are poorly characterized. This cohort study included patients with a history of ASCVD at baseline (6,841 patients), missing SDOH (8,453 participants), and missing covariates included in the pooled cohort equation (PCE). Participants were excluded if (1,472 people) or history of ASCVD was missing. Up incidents (297 people). Patient information including employment status (unemployed, underemployed, including retired), race and ethnicity (Chinese American, Hispanic, non-Hispanic black, non-Hispanic white), and education level (less than high school, high school) Characteristics (school, or higher education), income (less than $35,000, more than $35,000) were self-reported by participants. To understand the impact of her SDOH on ASCVD, time to first her ASCVD event was measured as the primary outcome. Cox proportional hazards models were used to understand the association between all her SDOH and incident ASCVD events. The final study included 26,316 participants (on average) [SD] Age at baseline, 61.0 [9.1] Year). Of the participants, 11,764 participants (44.7%) had at least one individual-level harmful SDOH, and 10,908 (41.5%) participants had at least one domain-level harmful SDOH. did. At the individual and community level, SDOH was associated with a greater risk of his ASCVD in education (individual: hazard ratio) [HR]1.39 [95% CI, 1.25-1.55]; Area: HR, 1.31 [95% CI, 1.20-1.42]) Low income (individual: 1.35 [95% CI, 1.25-1.47]; Area: HR, 1.28 [95% CI, 1.17-1.40]) and unemployment rate (individual: HR, 1.61 [95% CI, 1.24-2.10]; Area: HR, 1.25 [95% CI, 1.14-137]). Overall, his SDOH at both individual and community levels was associated with a higher risk of ASCVD events. Additionally, adding individual and local her-SDOH to his PCE slightly improved discrimination, while also improving the calibration for estimating her ASCVD risk for blacks.
Click to read the study on JAMA Network Open
Image: P.D.
©2024 2 Minute Medicine Co., Ltd.. All rights reserved. No work may be reproduced without the written consent of. 2 Minute Medicine Co., Ltd..Inquire about license here. None of the articles should be construed as medical advice and is not intended as such by the author or 2 Minute Medicine, Inc.
