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Associations Between Social Determinants of Health and Cardiovascular Health of US Adult Cancer Survivors (JACC: CardioOncology State-of-the-Art Review June 2024)
Associations Between Social Determinants of Health and Cardiovascular Health of US Adult Cancer Survivors



BACKGROUND: Relationships between the social determinants of health (SDOH) and cardiovascular health (CVH) of cancer survivors are underexplored.

OBJECTIVES: The 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.

JACC CardioOncology Editor-in-Chief and CME Editor

Bonnie Ky, MD, MSCE, FACC

Aniruddha Singh, MD


Important Dates

Date of Release: June 18, 2024
Term of Approval/Date of CME/MOC Expiration: June 17, 2025


Availability: On-Demand
Expires on Jun 17, 2025
Cost: FREE
Credit Offered:
1 CME Credit
1 ABP-MOC Point
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