Social determinants of health score: does it help identify those at higher cardiovascular risk?

Palacio, Ana; Mansi, Ruaa; Seo, David; Suarez, Maritza; Garay, Sylvia D.; Medina, Heidy N.; Tang, Fei; Tamariz, Leonardo

doi:10.37765/ajmc.2020.88504

Cited by 34 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 180 For example, the RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) 176 intervention sought to reduce hypertension control disparities through a collaborative care model that involved nurse care managers to coordinate care for patients with comorbidities, whereas the WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation) 179 intervention introduced lifestyle counseling from bilingual community health workers to improve cardiovascular behaviors among Latina women. Other interventions have targeted systematic approaches to SDoH integration in clinical care, such as developing a modified version of the Framingham CVD Risk Score 177 and adding measures of SDoH to improve the predictive accuracy of CVD risk models. 178 Major opportunities for integrating SDoH into clinical cardiovascular care can be found in standardizing electronic health records-based tools for SDoH assessments, facilitating panel management to identify and direct outreach to high risk patients, and tailoring clinical decisions to address environmental factors like housing conditions and health literacy.…”

Section: The Role Of Interventions In Addressing the Impact Of Social...mentioning

confidence: 99%

“…174 Additionally, the American Heart Association has suggested expanding SDoH education for cardiovascular health providers at all levels, improving tools using electronic health records to incorporate SDoH screening and referrals into clinical practice, and expanding SDoH interventions to address upstream determinants of CVD such as poverty, education, and health care coverage. 175 Previous studies demonstrated the success of efforts such as community health worker or patient navigator programs, 176 social risk score assessments, 177,178 and health behavior counseling 179 on reducing blood pressure, CVD risk, and LDL (low-density lipoprotein) levels. 180 For example, the RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) 176 intervention sought to reduce hypertension control disparities through a collaborative care model that involved nurse care managers to coordinate care for patients with comorbidities, whereas the WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation) 179 intervention introduced lifestyle counseling from bilingual community health workers to improve cardiovascular behaviors among Latina women.…”

Section: The Role Of Interventions In Addressing the Impact Of Social...mentioning

confidence: 99%

See 1 more Smart Citation

Social Determinants of Cardiovascular Disease

Powell‐Wiley

Baumer

Baah

et al. 2022

Circulation Research

392

213

View full text Add to dashboard Cite

Social determinants of health (SDoH), which encompass the economic, social, environmental, and psychosocial factors that influence health, play a significant role in the development of cardiovascular disease (CVD) risk factors as well as CVD morbidity and mortality. The COVID-19 pandemic and the current social justice movement sparked by the death of George Floyd have laid bare long-existing health inequities in our society driven by SDoH. Despite a recent focus on these structural drivers of health disparities, the impact of SDoH on cardiovascular health and CVD outcomes remains understudied and incompletely understood. To further investigate the mechanisms connecting SDoH and CVD, and ultimately design targeted and effective interventions, it is important to foster interdisciplinary efforts that incorporate translational, epidemiological, and clinical research in examining SDoH-CVD relationships. This review aims to facilitate research coordination and intervention development by providing an evidence-based framework for SDoH rooted in the lived experiences of marginalized populations. Our framework highlights critical structural/socioeconomic, environmental, and psychosocial factors most strongly associated with CVD and explores several of the underlying biologic mechanisms connecting SDoH to CVD pathogenesis, including excess stress hormones, inflammation, immune cell function, and cellular aging. We present landmark studies and recent findings about SDoH in our framework, with careful consideration of the constructs and measures utilized. Finally, we provide a roadmap for future SDoH research focused on individual, clinical, and policy approaches directed towards developing multilevel community-engaged interventions to promote cardiovascular health.

show abstract

Section: The Role Of Interventions In Addressing the Impact Of Social...mentioning

confidence: 99%

Section: The Role Of Interventions In Addressing the Impact Of Social...mentioning

confidence: 99%

Social Determinants of Cardiovascular Disease

Powell‐Wiley

Baumer

Baah

et al. 2022

Circulation Research

392

213

View full text Add to dashboard Cite

show abstract

“…A “SDOH score” based on several socioeconomic parameters (place of birth, education, financial strain, health literacy, stress level, living arrangements, social isolation, delay in care, census‐based income, and racial and ethnic minority background) has demonstrated a dose effect on cardiovascular risk factors such as systolic blood pressure, Framingham risk score, glycated hemoglobin, and smoking in a primary care cohort of 2876 patients in Miami, FL. 68 Similarly, having multiple affected areas of the SDOH has been associated with incident stroke in individuals younger than 75 years. 69 If this score is successfully validated in prospective cohorts of different CVDs, it could open a potential system‐level applicability to help identify those at the highest risk for CVD, and subsequently guide appropriate interventions.…”

Section: The Revolving Door Foundations: Differences Between Inpatien...mentioning

confidence: 99%

Locking the Revolving Door: Racial Disparities in Cardiovascular Disease

Velarde

Bravo‐Jaimes

Brandt

et al. 2023

JAHA

View full text Add to dashboard Cite

Racial disparities in cardiovascular disease are unjust, systematic, and preventable. Social determinants are a primary cause of health disparities, and these include factors such as structural and overt racism. Despite a number of efforts implemented over the past several decades, disparities in cardiovascular disease care and outcomes persist, pervading more the outpatient rather than the inpatient setting, thus putting racial and ethnic minority groups at risk for hospital readmissions. In this article, we discuss differences in care and outcomes of racial and ethnic minority groups in both of these settings through a review of registries. Furthermore, we explore potential factors that connote a revolving door phenomenon for those whose adverse outpatient environment puts them at risk for hospital readmissions. Additionally, we review promising strategies, as well as actionable items at the policy, clinical, and educational levels aimed at locking this revolving door.

show abstract

“…Although research exists on the impact of social determinants of health (SDOHs) on cardiovascular health, most of the existing evidence is based on individual SDOHs such as education and income or, at best, a composite of a few SDOH measures such as socioeconomic position, 4 , 5 with only few studies focusing on cumulative SDOH burden. 6 , 7 , 8 It is known that multiple SDOHs may interact to influence cardiovascular health. 9 Despite recent calls to better understand the impact of cumulative social disadvantage on overall cardiovascular health, 9 information remains sparse in understanding the impact of SDOHs on cardiovascular risk factors, subclinical CVD, and incident CVD.…”

Section: Clinical Perspectivementioning

confidence: 99%

Social Determinants of Cardiovascular Risk, Subclinical Cardiovascular Disease, and Cardiovascular Events

Acquah

Hagan

Javed

et al. 2023

JAHA

View full text Add to dashboard Cite

Background Although there is research on the impact of social determinants of health (SDOHs) on cardiovascular health, most existing evidence is based on individual SDOH components. We evaluated the impact of cumulative SDOH burden on cardiovascular risk factors, subclinical atherosclerosis, and incident cardiovascular disease events. Methods and Results We included 6479 participants from the MESA (Multi‐Ethnic Study of Atherosclerosis). A weighted aggregate SDOH score representing the cumulative number of unfavorable SDOHs, identified from 14 components across 5 domains (economic stability, neighborhood and physical environment, community and social context, education, and health care system access) was calculated and divided into quartiles (quartile 4 being the least favorable). The impact of cumulative SDOH burden on cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and obesity), systemic inflammation, subclinical atherosclerosis, and incident cardiovascular disease was evaluated. Increasing social disadvantage was associated with increased odds of all cardiovascular risk factors except dyslipidemia. Smoking was the risk factor most strongly associated with worse SDOH (odds ratio [OR], 2.67 for quartile 4 versus quartile 1 [95% CI, 2.13–3.34]). Participants within SDOH quartile 4 had 33% higher odds of increased high‐sensitivity C‐reactive protein (OR, 1.33 [95% CI, 1.11–1.60]) and 31% higher risk of all cardiovascular disease (hazard ratio, 1.31 [95% CI, 1.03–1.67]), yet no greater burden of subclinical atherosclerosis (OR, 1.01 [95% CI, 0.79–1.29]), when compared with those in quartile 1. Conclusions Increasing social disadvantage was associated with more prevalent cardiovascular risk factors, inflammation, and incident cardiovascular disease. These findings call for better identification of SDOHs in clinical practice and stronger measures to mitigate the higher SDOH burden among the socially disadvantaged to improve cardiovascular outcomes.

show abstract

Social determinants of health score: does it help identify those at higher cardiovascular risk?

Cited by 34 publications

References 0 publications

Social Determinants of Cardiovascular Disease

Social Determinants of Cardiovascular Disease

Locking the Revolving Door: Racial Disparities in Cardiovascular Disease

Social Determinants of Cardiovascular Risk, Subclinical Cardiovascular Disease, and Cardiovascular Events

Contact Info

Product

Resources

About