Table 2.
Summary of Findings: Systematic Reviews Assessing the Association Between SDoH and CVD Outcomes (n=70)
| SDoH | CVD outcomes (based on ICD‐10: I00–I99)* | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CVD (composite or unspecified) | Cerebrovascular disease | Ischemic heart disease | Other forms of heart disease | Diseases of arteries | ||||||||||||||
| Composite cardiovascular disease | Composite cardiovascular disease mortality | Stroke | Stroke mortality | Coronary artery/heart disease | Coronary artery/heart disease mortality | ischemic heart disease | Ischemic heart disease mortality | Myocardial infarction | Mortality due to myocardial infarction | Angina | Heart Failure | Heart disease | Heart disease mortality | Atrial fibrillation | Cardiomyopathy | Mortality due to cardiomyopathy | Peripheral arterial disease | |
| Theme 1: economic stability | ||||||||||||||||||
| Low composite socioeconomic status 24 , 42 , 43 , 61 , 71 , 72 , 73 , 74 , 75 | +(1) | +(1) | +(2) | +(2) | +(1), ±(1) | +(1) | +(1) | +(1) | ±(1) | +(1) | ||||||||
| Low education 61 , 62 , 71 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 | +(3), ±(1) | +(2) | +(4) | +(1) | +(3) | +(2) | +(1) | ±(1) | ||||||||||
| Low income 42 , 61 , 71 , 76 , 77 , 79 , 80 , 81 , 82 | n(1) | +(1), n(1), +(1) | +(1) | +(1) | +(1) | +(2) | +(1) | ±(1) | +(1) | |||||||||
| Lower occupation level 61 , 62 , 71 , 76 , 77 , 79 , 81 , 82 , 83 , 84 | +(4), ±(1) | +(2), n(1) | +(2), n(2) | +(1) | n(2) | +(1) | +(2) | +(2) | +(2) | +(2) | ||||||||
| Job insecurity 66 , 85 , 86 , 87 | +(1), n(1) | ±(1), n(1) | ||||||||||||||||
| Homelessness 57 , 88 | +(2) | +(1) | ±(1) | n(1) | n(1) | n(1) | ||||||||||||
| Food insecurity 57 | +(1) | +(1) | +(1) | +(1) | +(1) | |||||||||||||
| Theme 2: social and community context | ||||||||||||||||||
| Low/poor social support 63 , 66 , 67 , 68 , 87 , 89 , 90 | n(1) | n(1) | +(1), n(1) | +(1), n(1) | +(2), n(2) | +(1) | ||||||||||||
| Loneliness and social isolation 25 , 60 , 91 | +(3) | +(2) | n(1) | +(1) | ||||||||||||||
| Low social capital index 93 , 94 | n(2) | n(1) | +(1) | +(1) | ||||||||||||||
| Social capital (few social roles) 92 | +(1) | +(1) | ||||||||||||||||
| Social capital index (low social network) 58 | +(1) | n(1) | n(1) | |||||||||||||||
| Social capital index (low social cohesion) 58 | n(1) | n(1) | ||||||||||||||||
| Discrimination 56 | +(1) | +(1) | +(1) | n(1) | +(1) | +(1) | ||||||||||||
| Disparities in ethnicity and race 42 , 47 , 50 , 51 , 55 , 69 , 75 , 95 , 96 , 97 , 98 | +(1), ±(1), n(1) | +(1) | ±(1), n(1) | +(3), n(1) | +(1), ±(1) | ±(1) | ±(1) | n(1) | +(2) | +(1) | +(1), ±(1) | |||||||
| Theme 3: early childhood development | ||||||||||||||||||
| Childhood socioeconomic disadvantage 64 , 65 , 78 , 99 , 100 , 101 , 102 | +(1) | +(1) | +(3) | +(2) | +(1), ±(1) | +(1) | n(1) | n(1) | ||||||||||
| Adverse childhood events 48 , 52 , 53 , 102 , 103 , 104 , 105 , 106 , † | +(5) | +(2), n(1) | + | +(4) | +(4) | +(1) | ||||||||||||
| Theme 4: neighborhood and built environment | ||||||||||||||||||
| Violence during adulthood 54 , 59 , 106 , 107 , 108 , 109 | +(3), n(1) | ±(1), n(1) | ±(1) | +(1), ±(1) | ±(1) | |||||||||||||
| Conflict 70 | ±(1) | n(1) | n(1) | +(1) | n(1) | n(1) | ±(1) | +(1) | ||||||||||
| Adverse environment 49 , 110 , ‡ | +(2) | +(1), n(1) | +(1) | +(1) | +(1) | |||||||||||||
| Neighborhood socioeconomic disadvantage 26 , 77 , 81 , 111 | +(2) | +(2) | +(2), n(1) | +(2) | +(2) | |||||||||||||
The numbers in the parentheses indicate the number of reviews. + Indicates poorer/worse social determinant associated with an increased risk of CVD outcome (poorer SDoH→worse CVD outcome); ±, an approximately equal number of null and increased risk findings. CVD indicates cardiovascular disease; ICD‐10, International Classification of Diseases, Tenth Revision; n, null/no association; and SDoH, social determinants of health.
World Health Organization. ICD‐10. 2019. I00 to I99 indicate diseases of the circulatory system.
Childhood adverse events, such as lower childhood cumulative adverse events and adverse events specific to abuse, neglect, and violence.
Inaccessibility of health care facilities, environmental noise, proximity to a major road/high traffic density, high crime rate, reduced access to food stores and parks/recreation, and increased access to fast‐food restaurants.