Key result
Having ≥1 unfavorable social determinants of health (reported by 84% of participants) was associated with significantly higher odds of high ASCVD risk, which was present in 63% of the cohort.
Why the study?
Social determinants of health are linked with cardiovascular health, but timely community-based atherosclerotic cardiovascular disease risk assessment is often limited.
Are unfavorable social determinants of health associated with high ASCVD risk in Black adults?
Cross-Sectional (n=118)
Yes
Are unfavorable social determinants of health associated with high ASCVD risk in Black adults?
Unfavorable social determinants of health, including low income and unemployment, are strongly associated with high estimated ASCVD risk among Black adults.
Supports SDOH screening in community risk assessment for Black adults; leaves open causality and whether interventions reduce ASCVD risk.
BACKGROUND: Social determinants of health (SDOHs) are linked with cardiovascular health, yet timely community-based atherosclerotic cardiovascular disease (ASCVD) risk assessment is often limited. We examined the associations between SDOHs and ASCVD risk among adults in Baltimore. METHODS: This cross-sectional study of 4 Black faith-based communities in Baltimore assessed the cardiovascular health of adults aged 40 to 79 years. We estimated ASCVD risk using the 2013 American College of Cardiology/American Heart Association pooled cohort equations (PCE) and dichotomized risk as high or low. SDOHs were quantified with an 8-item score drawn from the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences tool. We fit linear and logistic regression models to examine the association between SDOHs and high ASCVD risk after adjusting for age, sex, body mass index, and alcohol use. RESULTS: Among 118 Black adults, the mean±SD age was 64±9 years, with 85% women. Overall, the mean ASCVD risk score was 13.1%, and the median (interquartile range) was 10.2% (5.0%-19.0%). The majority (63%) had high ASCVD risk ( ≥7.5%). About 84% of participants reported ≥1 unfavorable SDOHs. In the fully adjusted model, low income, unemployment, having no primary care provider, and having ≥1 unfavorable SDOHs were associated with high ASCVD risk. We also observed significantly higher odds of ASCVD among individuals with 2 unfavorable SDOHs compared with those with none. CONCLUSIONS: We found associations between lower income, unemployment, and multiple unfavorable SDOHs with greater ASCVD risk. Our findings suggest the need for socioeconomic policies to improve cardiovascular health, particularly among Black individuals.
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Hinneh et al. (2025) conducted a cross-sectional in Atherosclerotic cardiovascular disease risk (n=118). Unfavorable social determinants of health (SDOHs) vs. No unfavorable SDOHs was evaluated on High ASCVD risk (≥7.5%). Having ≥1 unfavorable social determinants of health (reported by 84% of participants) was associated with significantly higher odds of high ASCVD risk, which was present in 63% of the cohort.
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