Key result
Cumulative adverse SDOH linked to ~2.2-fold higher odds of CVD in older adults.
Why the study?
The association between socioeconomic and social determinants of health, including loneliness and social support, with cardiovascular disease among U.S. adults aged 65 years and older was not well characterized.
Do adverse social determinants of health (SDOH) and loneliness increase the odds of cardiovascular disease in U.S. adults aged 65 years and older?
Cross-Sectional (n=9,953)
Do adverse social determinants of health (SDOH) and loneliness increase the odds of cardiovascular disease in U.S. adults aged 65 years and older?
Odds Ratio: 2.25 (95% CI 1.57–3.23)
Economic disadvantage, loneliness, adverse neighborhood environments, and cumulative social disadvantage are independently associated with higher odds of cardiovascular disease among older U.S. adults.
May flag higher CVD odds in older adults; hypothesis-generating for prospective SDOH interventions.
Objective: To examine the association between socioeconomic and social determinants of health (SDOH), particularly loneliness and social support, with cardiovascular disease (CVD) among U.S. adults aged ≥65 years and cumulative social disadvantage. Methods: This analytical cross-sectional study used the 2024 National Health Interview Survey (NHIS). Adults aged ≥65 years were included (n=9,953). Exposures included income relative to the federal poverty threshold, loneliness, perceived social support, educational attainment, health insurance, and neighborhood environment. A cumulative SDOH burden score was created by summing adverse SDOH characteristics. Survey-weighted logistic regression estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, race/ethnicity, marital status, and geographic region. Smoking, alcohol use, body mass index, and physical activity were evaluated as potential mediators. Results: A total of 17.7% of 9,953 participants reported CVD. Living below poverty (OR 1.34; 95% CI 1.05–1.70), near poverty (OR 1.25; 95% CI 1.06–1.47), moderate loneliness (OR 1.38; 95% CI 1.17–1.63), high loneliness (OR 1.47; 95% CI 1.12–1.94), and lacking walkable neighborhoods (OR 1.24; 95% CI 1.08–1.42) were associated with higher odds of CVD. Participants with three adverse SDOH had more than twice the odds of CVD than those with none (OR 2.25; 95% CI 1.57–3.23). Conclusions: Economic disadvantage, loneliness, adverse neighborhood environments, and cumulative social disadvantage were independently associated with CVD among older U.S. adults, highlighting the need to address multiple social determinants to reduce cardiovascular risk.
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Cintron et al. (2026) conducted a cross-sectional in Cardiovascular disease (n=9,953). Three adverse social determinants of health (SDOH) vs. No adverse SDOH was evaluated on Cardiovascular disease (CVD) (OR 2.25, 95% CI 1.57-3.23). Cumulative social disadvantage (three adverse SDOH) was associated with more than twice the odds of cardiovascular disease in older U.S. adults compared to having none (OR 2.25; 95% CI 1.57-3.23).
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