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Introduction: Cardiovascular disease remains a leading cause of death in the U.S. Although social risks have been linked to cardiovascular health, our understanding of how co-occurring social risk factors collectively influence cardiovascular health remains limited. We sought to evaluate the contributions of cumulative social risks (SR) to cardiovascular health in US adults. Methods: We analyzed cross-sectional data from the National Health and Nutrition Examination Survey (2013-2020). Social risks (low family income, low education level, minority race/ethnic group, single-living status, uninsured, unemployed) were examined via self-report questionnaires. Cardiovascular health was modeled as quartiles of Life’s Essential 8 (LE8) scores. Cumulative SR was modeled as number of SR (0,1,2,3, and ≥ 4). Multinomial logistic regression models were used to assess the association between cumulative SR and LE8 scores, adjusting for age and gender. Results: Among 13,982 US adults (mean age 32 ± 25; 51% female), the prevalence of 0 SR, 1 SR, 2 SR, 3 SR, and ≥ 4 SR, were 16%, 36%, 29%, 13%, and 6%, respectively. Adults with one or more social risks had significantly higher odds of having worse LE8 scores across multiple quartiles. Compared to adults with the lowest SR (0), those with the highest SR (≥ 4) had significantly higher odds of worse LE8 scores (Quartile 1 adjusted odds ratio (aOR) 7.11; 95% CI 5.32-9.50; Quartile 2 aOR 5.22; 95% CI 3.88-7.04; Quartile 3 aOR 3.39; 95% CI 2.52-4.54). Conclusion: US adults with an increasing number of social risks were more likely to have worse cardiovascular health scores. Social and economic policies are necessary to address adverse social determinants to improve cardiovascular health.
Metlock et al. (Tue,) studied this question.
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