Full Citation
Title: Social Determinants of Health Among Non-Elderly Adults With Stroke in the United States
Citation Type: Journal Article
Publication Year: 2022
ISBN:
ISSN: 0025-6196
DOI: 10.1016/J.MAYOCP.2021.08.024
NSFID:
PMCID:
PMID: 35120692
Abstract: Objective: To examine the association of social determinants of health (SDOH) on prevalence of stroke in non-elderly adults (<65 years of age). Methods: We used the National Health Interview Survey (2013–2017) database. The study population was stratified into younger (<45 years of age) and middle age (45 to 64 years of age) adults. For each individual, an SDOH aggregate score was calculated representing the cumulative number of individual unfavorable SDOH (present vs absent), identified from 39 subcomponents across five domains (economic stability, neighborhood, community and social context, food, education, and health care system access) and divided into quartiles (quartile 1, most favorable; quartile 4, most unfavorable). Multivariable models tested the association between SDOH score quartiles and stroke. Results: The age-adjusted prevalence of stroke was 1.4% in the study population (n=123,631; 58.2% (n=71,956) in patients <45 years of age). Young adults reported approximately 20% of all strokes. Participants with stroke had unfavorable responses to 36 of 39 SDOH; nearly half (48%) of all strokes were reported by participants in the highest SDOH score quartile. A stepwise increase in age-adjusted stroke prevalence was observed across increasing quartiles of SDOH (first, 0.6%; second, 0.9%; third, 1.4%; and fourth, 2.9%). After accounting for demographics and cardiovascular disease risk factors, participants in the fourth vs first quartile had higher odds of stroke (odds ratio, 2.78; 95% CI, 2.25 to 3.45). Conclusion: Nearly half of all non-elderly individuals with stroke have an unfavorable SDOH profile. Standardized assessment of SDOH risk burden may inform targeted strategies to mitigate disparities in stroke burden and outcomes in this population.
Url: https://www.sciencedirect.com/science/article/pii/S0025619621006492
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Authors: Khan, Safi U.; Acquah, Isaac; Javed, Zulqarnain; Valero-Elizondo, Javier; Yahya, Tamer; Blankstein, Ron; Virani, Salim S.; Blaha, Michael J.; Hyder, Adnan A.; Dubey, Prachi; Vahidy, Farhaan S.; Cainzos-Achirica, Miguel; Nasir, Khurram
Periodical (Full): Mayo Clinic Proceedings
Issue: 2
Volume: 97
Pages: 238-249
Data Collections: IPUMS Health Surveys - NHIS
Topics: Aging and Retirement, Health
Countries: