Cardiovascular
Association of Coronary Heart Disease and Stroke with Adverse Social Determinants of Health and Health-Related Social Needs Among US Adults Aged ≥18 Years Guixiang Zhao* Guixiang Zhao Machell Town Jing Fang Fatima Coronado Paul Eke
Background: Social determinants of health (SDOH) and individual-based health-related social needs (HRSN) have emerged as non-medical factors that influence people’s health. We examined the associations of coronary heart disease (CHD) and stroke with adverse SDOH and HRSN measures among US adults.
Methods: SDOH/HRSN data collected through the Behavioral Risk Factor Surveillance System in 2022 were analyzed to measure life satisfaction, social and emotional support, loneliness, employment stability, food security, housing stability, transportation access, utilities security, mental stress, and cost barrier for needed medical care. Weighted prevalences for history of CHD and stroke were estimated by individual or cumulative SDOH/HRSN measures, and the associations were assessed by conducting log-linear regression analyses with adjustment for potential confounders.
Results: The prevalences of CHD and stroke were significantly higher among adults with most adverse SDOH and HRSN compared to those without. After adjustment for demographic characteristics and traditional cardiovascular risk factors, the adjusted relative prevalences for CHD and stroke remained significantly higher for adults with most adverse SDOH and HRSN compared to those without. The relative increases ranged from 13% for CHD and 14% for stroke among those lacking social and emotional support, to 64% and 78%, respectively, for those lacking reliable transportation. The adjusted prevalences of CHD and stroke were linearly and positively associated with the SDOH/HRSN composite score.
Conclusions: The prevalences of CHD and stroke were significantly higher among adults with underlying contributing factors to health inequities. Reducing CHD and stroke calls for an integrated approach that addresses disparities in SDOH and HRSN, along with medical therapy and lifestyle modifications.