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Developing a Novel Index for Individual-Level Social Determinants and Cardiovascular Diseases in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Author

Listed:
  • Tao Gao

    (Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
    Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA)

  • Yinan Zheng

    (Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
    Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA)

  • Brian Joyce

    (Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
    Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA)

  • Lei Liu

    (Division of Biostatistics, Washington University in St. Louis, St. Louis, MO 63110, USA)

  • Lili Liu

    (Division of Biostatistics, Washington University in St. Louis, St. Louis, MO 63110, USA)

  • Catarina Kiefe

    (Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA)

  • Sarah Forrester

    (Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA)

  • Bing Yu

    (Department of Epidemiology and Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA)

  • Ankeet Bhatt

    (Division of Research, Kaiser Permanente San Francisco Medical Center, San Francisco, CA 94588, USA)

  • Penny Gordon-Larsen

    (Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA)

  • Donald Lloyd-Jones

    (Preventive Medicine & Epidemiology Section, and Framingham Center for Population & Prevention Science, Boston University School of Medicine, Boston, MA 02118, USA)

  • Kai Zhang

    (Department of Population and Community Health, College of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX 76107, USA)

  • Lifang Hou

    (Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
    Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA)

Abstract

Background: Social determinants of health (SDH) have been found to contribute to cardiovascular risk and the development of cardiovascular disease (CVD). However, few studies have examined early-life exposure to SDH and the combined effect of multiple SDH measures on CVD. There is an urgent need to develop an SDH index for use in practice and clinical settings. Methods: A total of 3189 participants from the CARDIA Study who had chest CT scans at the year-25 (Y25) visit were included in this study. Personal and parental SDH measures, including education, occupation, income, financial strain, and childhood family environment, were obtained through interviews. The participants’ coronary artery calcification (CAC) was measured using chest CT scans, and left-ventricular mass (LVM) was measured using M-mode echocardiography. The values of the individual social determinants of health (iSDH) index were determined based on individual-level measures and CAC using a supervised learning method—the Boosted Regression Tree (BRT) model. This index’s association with the LVM index (LVMI) was evaluated as an external validation using linear regression models adjusting for race, sex, BMI, smoking status, alcohol intake, and physical activity. Results: Each one-standard-deviation (SD) increase in the iSDH index was associated with an increase in LVMI ranging from 0.376 (95% CI −0.016, 0.767) at year 0 to 0.468 (95% CI 0.115, 0.821) at year 20. The association between the iSDH index and the LVMI was more pronounced as the participants aged. Also, the iSDH indices were more strongly associated with LVMI among Black participants (β = 0.969, 95% CI = 0.081, 1.858) than White participants (β = 0.202, 95% CI = −0.228, 0.633) at year 5. Conclusions: Higher iSDH indices in early adulthood were associated with increased LVMI values in midlife. The association between the iSDH index and CVD was stronger among Black adults than with White adults.

Suggested Citation

  • Tao Gao & Yinan Zheng & Brian Joyce & Lei Liu & Lili Liu & Catarina Kiefe & Sarah Forrester & Bing Yu & Ankeet Bhatt & Penny Gordon-Larsen & Donald Lloyd-Jones & Kai Zhang & Lifang Hou, 2025. "Developing a Novel Index for Individual-Level Social Determinants and Cardiovascular Diseases in the Coronary Artery Risk Development in Young Adults (CARDIA) Study," IJERPH, MDPI, vol. 22(3), pages 1-10, March.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:3:p:422-:d:1611798
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    References listed on IDEAS

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    1. Winkleby, M.A. & Jatulis, D.E. & Frank, E. & Fortmann, S.P., 1992. "Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease," American Journal of Public Health, American Public Health Association, vol. 82(6), pages 816-820.
    2. Jie Zhang & Xiangli Gu & Xiaoxia Zhang & Jihye Lee & Mei Chang & Tao Zhang, 2021. "Longitudinal Effects of Motivation and Physical Activity on Depressive Symptoms among College Students," IJERPH, MDPI, vol. 18(10), pages 1-11, May.
    3. Walsemann, Katrina M. & Goosby, Bridget J. & Farr, Deeonna, 2016. "Life course SES and cardiovascular risk: Heterogeneity across race/ethnicity and gender," Social Science & Medicine, Elsevier, vol. 152(C), pages 147-155.
    4. Cushing, L. & Faust, J. & August, L.M. & Cendak, R. & Wieland, W. & Alexeeff, G., 2015. "Racial/ethnic disparities in cumulative environmental health impacts in California: Evidence from a statewide environmental justice screening tool (CalEnviroScreen 1.1)," American Journal of Public Health, American Public Health Association, vol. 105(11), pages 2341-2348.
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