TY - JOUR
T1 - Social Determinants of Health Score
T2 - Does It Help Identify Those at Higher Cardiovascular Risk?
AU - Palacio, Ana
AU - Mansi, Ruaa
AU - Seo, David
AU - Suarez, Maritza
AU - Garay, Sylvia
AU - Medina, Heidy
AU - Tang, Fei
AU - Tamariz, Leonardo
N1 - Funding Information:
Research reported in this publication was conducted under the auspices of the Precision Medicine and Health Disparities Collaborative (Vanderbilt-Meharry-Miami Center of Excellence in Precision Medicine and Population Health), supported by the National Institute on Minority Health and Health Disparities and the National Human Genome Research Institute of the National Institutes of Health under award number U54MD010722.
PY - 2020
Y1 - 2020
N2 - OBJECTIVES: Cardiovascular disease (CVD) continues to disproportionately affect disadvantaged populations, leading to calls to address social determinants of health (SDOH) as a preventive strategy. Our aim is to create a weighed SDOH score and to test the impact of each SDOH factor on the Framingham risk score (FRS) and on individual traditional CVD risk factors. STUDY DESIGN: We conducted a retrospective cohort study. METHODS: We included patients seen at a primary care clinic at UHealth/University of Miami Health System who answered a SDOH survey between September 16, 2016, and September 10, 2017. The survey included SDOH domains recommended by the American Heart Association position statement and by the National Academy of Medicine. We selected the FRS as well as all traditional CVD risk factors as our outcome metrics. RESULTS: We included 2876 patients. The mean (SD) age of our cohort was 53.8 (15.8) years, 61% were female, 9% were Black, 38% were Hispanic, and 87% reported speaking English. The statistically significant β coefficients in the FRS model corresponded to being born outside of the United States, being a racial minority, living alone, having a high social isolation score, and having a low geocoded median household income (P<.01). Increasing quartile of SDOH score was significantly associated with higher systolic blood pressure, FRS, glycated hemoglobin, and smoking pack-years (P<.05). It was also associated with fewer minutes spent exercising weekly (P<.01). CONCLUSIONS: The addition of self-reported SDOH data has a dose effect on CVD risk factors. Future studies should address how to intervene to address social factors.
AB - OBJECTIVES: Cardiovascular disease (CVD) continues to disproportionately affect disadvantaged populations, leading to calls to address social determinants of health (SDOH) as a preventive strategy. Our aim is to create a weighed SDOH score and to test the impact of each SDOH factor on the Framingham risk score (FRS) and on individual traditional CVD risk factors. STUDY DESIGN: We conducted a retrospective cohort study. METHODS: We included patients seen at a primary care clinic at UHealth/University of Miami Health System who answered a SDOH survey between September 16, 2016, and September 10, 2017. The survey included SDOH domains recommended by the American Heart Association position statement and by the National Academy of Medicine. We selected the FRS as well as all traditional CVD risk factors as our outcome metrics. RESULTS: We included 2876 patients. The mean (SD) age of our cohort was 53.8 (15.8) years, 61% were female, 9% were Black, 38% were Hispanic, and 87% reported speaking English. The statistically significant β coefficients in the FRS model corresponded to being born outside of the United States, being a racial minority, living alone, having a high social isolation score, and having a low geocoded median household income (P<.01). Increasing quartile of SDOH score was significantly associated with higher systolic blood pressure, FRS, glycated hemoglobin, and smoking pack-years (P<.05). It was also associated with fewer minutes spent exercising weekly (P<.01). CONCLUSIONS: The addition of self-reported SDOH data has a dose effect on CVD risk factors. Future studies should address how to intervene to address social factors.
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U2 - 10.37765/ajmc.2020.88504
DO - 10.37765/ajmc.2020.88504
M3 - Article
C2 - 33094943
AN - SCOPUS:85094683901
VL - 26
SP - E312-E318
JO - American Journal of Managed Care
JF - American Journal of Managed Care
SN - 1088-0224
IS - 10
ER -