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Individual and cumulative effects of social determinants of health on cardiovascular disease: Gender-specific insights from a cross-sectional NHANES study

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  • Xiuming Yang
  • Jiahui Zhou
  • Feier Wu
  • Zehu Xue
  • Zongliang Yu

Abstract

Objective: This study aimed to examine the associations of individual and cumulative social determinants of health (SDoH) with cardiovascular disease (CVD) prevalence and sex-specific disparities among U.S. adults. Methods: Employing a cross-sectional design, we analyzed data from the nationally representative National Health and Nutrition Examination Survey (NHANES, 2005–2018). Five core SDoH domains were operationalized through eight validated sub-indicators. Associations between individual and cumulative SDoH and CVD prevalence were assessed using survey-weighted multivariate logistic regression, with sex-stratified analyses. Results: In this cross-sectional sample of 35,781 participants, adverse individual SDoH and higher cumulative adverse SDoH were associated with higher odds of prevalent CVD. In the fully adjusted model (Model 2), unemployment showed a large association with prevalent CVD (AOR = 2.27, 95% CI: 2.01–2.57). In sex-stratified analyses, point estimates for some SDoH indicators were higher in women than in men, but 95% confidence intervals overlapped for many comparisons and sex-by-SDoH interaction tests were not statistically significant (all P for interaction > 0.05). Among individual SDoH indicators, unemployment and low income (PIR

Suggested Citation

  • Xiuming Yang & Jiahui Zhou & Feier Wu & Zehu Xue & Zongliang Yu, 2026. "Individual and cumulative effects of social determinants of health on cardiovascular disease: Gender-specific insights from a cross-sectional NHANES study," PLOS ONE, Public Library of Science, vol. 21(3), pages 1-15, March.
    • Handle: RePEc:plo:pone00:0344108
    DOI: 10.1371/journal.pone.0344108
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