This study by Zhu et al 1 presents an analysis conducted using National Health and Nutrition Examination Survey data from 1999 to 2018 to identify the association between social determinants of health (SDOH) and cardiovascular-kidney-metabolic syndrome (CKM) by stage. 1 The result is as one would expect: a gradient of CKM severity that increased as detrimental SDOH accumulated. For example, participants with 2 or more adverse SDOH were more likely to have advanced CKM stage than those with fewer than 2 adverse SDOH (age-standardized prevalence of advanced CKM, 15.8% [95% CI, 15.2%-16.5%] vs 10.5% [95% CI, 9.9%-11.1%]). Demonstrating these outcomes in a US population is important and validates similar findings in a Chinese cohort. 2 Presentation of such