Danish Iltaf Satti MBBS , Jeffrey Shi Kai Chan MBChB, MPH , Edward Christopher Dee MD , Yan Hiu Athena Lee , Abraham Ka Chung Wai MBChB , Sourbha S. Dani MD, MSc , Salim S. Virani MD, PhD , Michael D. Shapiro DO, MCR , Garima Sharma MBBS , Tong Liu MD, PhD , Gary Tse MD, PhD
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SDOH was quantified with a 6-domain, 38-item score, consistent with the Centers for Disease Control and Prevention recommendations (higher score indicated worse deprivation). CVH was quantified based on the American Heart Association’s Life’s Essential 8, but due to unavailable detailed dietary data, a 7-item CVH score was used, with a higher score indicating worse CVH. Survey-specific multivariable Poisson regression was used to test associations between SDOH quartiles and CVH.</p></div><div><h3>Results</h3><p>Altogether, 8,254 subjects were analyzed, representing a population of 10,887,989 persons. Worse SDOH was associated with worse CVH (highest vs lowest quartile: risk ratio 1.30; 95% CI: 1.25-1.35; <em>P</em> < 0.001), with a grossly linear relationship between SDOH and CVH scores. Subgroup analysis found significantly stronger associations in younger participants (<em>P</em><sub>interaction</sub> = 0.026) or women (<em>P</em><sub>interaction</sub> = 0.001) but without significant interactions with race (<em>P</em><sub>interaction</sub> = 0.051). Higher scores in all domains of SDOH were independently associated with worse CVH (all <em>P</em> < 0.001). Higher SDOH scores were also independently associated with each component of the CVH score (all <em>P</em> < 0.05 for highest SDOH quartile).</p></div><div><h3>Conclusions</h3><p>An unfavorable SDOH profile was independently associated with worse CVH among adult cancer survivors in the United States.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":null,"pages":null},"PeriodicalIF":12.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087323002569/pdfft?md5=2119c68ae8b1a4b219ad134e2bdd5a5c&pid=1-s2.0-S2666087323002569-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Associations Between Social Determinants of Health and Cardiovascular Health of U.S. Adult Cancer Survivors\",\"authors\":\"Danish Iltaf Satti MBBS , Jeffrey Shi Kai Chan MBChB, MPH , Edward Christopher Dee MD , Yan Hiu Athena Lee , Abraham Ka Chung Wai MBChB , Sourbha S. Dani MD, MSc , Salim S. Virani MD, PhD , Michael D. Shapiro DO, MCR , Garima Sharma MBBS , Tong Liu MD, PhD , Gary Tse MD, PhD\",\"doi\":\"10.1016/j.jaccao.2023.07.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Relationships between the social determinants of health (SDOH) and cardiovascular health (CVH) of cancer survivors are underexplored.</p></div><div><h3>Objectives</h3><p>This study sought to investigate associations between the SDOH and CVH of adult cancer survivors.</p></div><div><h3>Methods</h3><p>Data from the U.S. National Health Interview Survey (2013-2017) were used. Participants reporting a history of cancer were included, excluding those with only nonmelanotic skin cancer, or with missing data for any domain of SDOH or CVH. SDOH was quantified with a 6-domain, 38-item score, consistent with the Centers for Disease Control and Prevention recommendations (higher score indicated worse deprivation). CVH was quantified based on the American Heart Association’s Life’s Essential 8, but due to unavailable detailed dietary data, a 7-item CVH score was used, with a higher score indicating worse CVH. Survey-specific multivariable Poisson regression was used to test associations between SDOH quartiles and CVH.</p></div><div><h3>Results</h3><p>Altogether, 8,254 subjects were analyzed, representing a population of 10,887,989 persons. Worse SDOH was associated with worse CVH (highest vs lowest quartile: risk ratio 1.30; 95% CI: 1.25-1.35; <em>P</em> < 0.001), with a grossly linear relationship between SDOH and CVH scores. Subgroup analysis found significantly stronger associations in younger participants (<em>P</em><sub>interaction</sub> = 0.026) or women (<em>P</em><sub>interaction</sub> = 0.001) but without significant interactions with race (<em>P</em><sub>interaction</sub> = 0.051). Higher scores in all domains of SDOH were independently associated with worse CVH (all <em>P</em> < 0.001). Higher SDOH scores were also independently associated with each component of the CVH score (all <em>P</em> < 0.05 for highest SDOH quartile).</p></div><div><h3>Conclusions</h3><p>An unfavorable SDOH profile was independently associated with worse CVH among adult cancer survivors in the United States.</p></div>\",\"PeriodicalId\":48499,\"journal\":{\"name\":\"Jacc: Cardiooncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":12.0000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666087323002569/pdfft?md5=2119c68ae8b1a4b219ad134e2bdd5a5c&pid=1-s2.0-S2666087323002569-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jacc: Cardiooncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666087323002569\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jacc: Cardiooncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666087323002569","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Associations Between Social Determinants of Health and Cardiovascular Health of U.S. Adult Cancer Survivors
Background
Relationships between the social determinants of health (SDOH) and cardiovascular health (CVH) of cancer survivors are underexplored.
Objectives
This study sought to investigate associations between the SDOH and CVH of adult cancer survivors.
Methods
Data from the U.S. National Health Interview Survey (2013-2017) were used. Participants reporting a history of cancer were included, excluding those with only nonmelanotic skin cancer, or with missing data for any domain of SDOH or CVH. SDOH was quantified with a 6-domain, 38-item score, consistent with the Centers for Disease Control and Prevention recommendations (higher score indicated worse deprivation). CVH was quantified based on the American Heart Association’s Life’s Essential 8, but due to unavailable detailed dietary data, a 7-item CVH score was used, with a higher score indicating worse CVH. Survey-specific multivariable Poisson regression was used to test associations between SDOH quartiles and CVH.
Results
Altogether, 8,254 subjects were analyzed, representing a population of 10,887,989 persons. Worse SDOH was associated with worse CVH (highest vs lowest quartile: risk ratio 1.30; 95% CI: 1.25-1.35; P < 0.001), with a grossly linear relationship between SDOH and CVH scores. Subgroup analysis found significantly stronger associations in younger participants (Pinteraction = 0.026) or women (Pinteraction = 0.001) but without significant interactions with race (Pinteraction = 0.051). Higher scores in all domains of SDOH were independently associated with worse CVH (all P < 0.001). Higher SDOH scores were also independently associated with each component of the CVH score (all P < 0.05 for highest SDOH quartile).
Conclusions
An unfavorable SDOH profile was independently associated with worse CVH among adult cancer survivors in the United States.
期刊介绍：
JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge.
The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention.
Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.
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