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June 10, 2026Diabetes

1277-OR: Social Determinants of Health Score and Risk of Coronary Heart Disease in a Diverse Cohort of People with Type 2 Diabetes

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Key result

Higher SDOH score linked to ~33% greater incident CHD risk per SD in T2D.

  • HR 1.33
  • 95% CI 1.30-1.36
  • P<0.001
  • n=71,916

Why the study?

To examine the association between a composite social determinant of health score and incident coronary heart disease, adjusting for genetic susceptibility and traditional risk factors, among adults with T2D.

Is a higher social determinant of health (SDOH) score associated with an increased risk of incident coronary heart disease in adults with type 2 diabetes?

Population

71,916 All of Us Research Program participants with T2D free of CHD

Comparison

SDOH-CHD score per 1-SD increase and across tertiles

Design

Cohort study

Follow-up

Median 6.6 years

Authors

DLDANTING LIUniversity of New OrleansYLYou LüTulane University楚楚三Baton Rouge Clinic

Discussion

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Implication

May refine CHD risk stratification in T2D beyond genetics and traditional factors; leaves open whether SDOH interventions alter outcomes.

Key Points

  • This research examines how a composite social determinant of health score correlates with incident coronary heart disease among adults with type 2 diabetes, accounting for genetic and traditional risk factors.
  • Analysis included 71,916 All of Us Research Program participants with type 2 diabetes without coronary heart disease.
  • Composite SDOH score was created from 21 measures across five domains and imputed missing data using random forests.
  • Cox proportional hazards models assessed the relationship between SDOH score increases and coronary heart disease risk over a median follow-up of 6.6 years.
  • Over the follow-up period, 7,643 individuals developed coronary heart disease.
  • Each 1-SD increase in the SDOH score led to a 32% increase in CHD risk (HR 1.33; 95% CI 1.30-1.36).
  • Adjusted HRs for CHD were 1.48 (95% CI 1.40-1.58) for the middle SDOH tertile and 1.90 (95% CI 1.78-2.02) for the highest tertile (p-trend <0.001).

Study Design

Type

Cohort (n=71,916)

Multicenter

Yes

Structured PICO

Is a higher social determinant of health (SDOH) score associated with an increased risk of incident coronary heart disease in adults with type 2 diabetes?

P
Population
71,916 adults with type 2 diabetes and no prior coronary heart disease, followed for a median of 6.6 years.
E
Exposure
Higher composite social determinant of health (SDOH) score (evaluated per 1-SD increase and across tertiles)
C
Comparator
Lower SDOH score (lowest tertile)
O
Outcome
Incident coronary heart disease (CHD)hard clinical

Main Result

Hazard Ratio: 1.33 (95% CI 1.3–1.36)

p-value: p=<0.001

A higher composite social determinant of health score is independently associated with a significantly increased risk of incident coronary heart disease in adults with type 2 diabetes.

Cite This Study

LI et al. (2026) conducted a cohort in Type 2 Diabetes (n=71,916). Social determinant of health (SDOH) score vs. Lowest SDOH tertile was evaluated on Incident coronary heart disease (CHD) (HR 1.33, 95% CI 1.30-1.36, p=<0.001). A higher social determinant of health score was associated with increased risk of incident coronary heart disease in adults with type 2 diabetes (HR 1.33 per 1-SD increase; 95% CI 1.30-1.36).

synapsesocial.com/papers/6a2900ff6f82f25be989d768https://doi.org/10.2337/db26-1277-or
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 12263-P: Independent Association of Social Determinants of Health Score and Risk of Mild Cognitive Impairment and Dementia among People with Type 2 Diabetes: Findings from the All of Us Research Program2026
  2. 2Social Determinants of Health and Incident Type 2 Diabetes Risk: Real-World Evidence From the Houston Methodist Cardiovascular Learning Health System Registry2026 · 1 citations
  3. 3Social Determinants of Health and Cardiovascular Risk among Adults with Diabetes: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study2024 · 7 citations
  4. 4Abstract TH902: Joint Impact of Social Determinants of Health Burden and Coronary Artery Disease on All-Cause and Cardiovascular Mortality: 18-Year Follow-up From National Health And Nutrition Examination Survey 2000–20182026
  5. 5Social Determinants of Health Among Chinese Americans at Risk for Diabetes in a Mobile Diabetes Prevention Trial: Cross-Sectional Baseline Analysis2026