Table 3.
Association between cumulative SDOH risk and HALex-based outcomes, stratified by sex and race/ethnicity; National Health Interview Survey 2013–2017
| Stratifying variable | Cumulative SDOH | HALex score (β, 95% CI) |
Poor HALex (OR, 95% CI) |
|---|---|---|---|
| Sex | |||
| Male | SDoH index* | -0.006 (-0.007, -0.006) | 1.12 (1.11, 1.13) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.029 (-0.033, -0.025) | 2.00 (1.79, 2.44) | |
| SDOH-Q3 | -0.045 (-0.049, -0.042) | 2.86 (2.59, 3.15) | |
| SDOH-Q4 | -0.089 (-0.094, -0.084) | 5.38 (4.83, 6.00) | |
| Female | SDoH index* | -0.006 (-0.006, -0.006) | 1.11 (1.10, 1.11) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.028 (-0.032, -0.024) | 1.77 (1.61, 1.94) | |
| SDOH-Q3 | -0.042 (-0.046, -0.039) | 2.43 (2.24, 2.64) | |
| SDOH-Q4 | -0.085 (-0.089, -0.080) | 4.66 (4.25, 5.10) | |
| Age group | |||
| 18–39 years | SDoH index* | -0.004 (-0.004, -0.004) | 1.08 (1.07, 1.09) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.020 (-0.025, -0.016) | 2.06 (1.69, 2.52) | |
| SDOH-Q3 | -0.027 (-0.030, -0.023) | 2.43 (2.06, 2.86) | |
| SDOH-Q4 | -0.055 (-0.060, -0.050) | 4.02 (3.39, 4.77) | |
| 40–54 years | SDoH index* | -0.006 (-0.007, -0.006) | 1.12 (1.11, 1.12) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.019 (-0.024, -0.014) | 1.86 (1.58, 2.18) | |
| SDOH-Q3 | -0.033 (-0.038, -0.029) | 2.46 (2.14, 2.83) | |
| SDOH-Q4 | -0.087 (-0.093, -0.081) | 5.20 (4.51, 6.00) | |
| 55–64 years | SDoH index* | -0.009 (-0.009, -0.008) | 1.13 (1.12, 1.14) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.025 (-0.032, -0.019) | 1.70 (1.46, 1.98) | |
| SDOH-Q3 | -0.058 (-0.064, -0.051) | 2.69 (3.04, 3.06) | |
| SDOH-Q4 | -0.125 (-0.135, -0.116) | 5.65 (4.91, 6.50) | |
| ≥ 65 years | SDoH index* | -0.010 (-0.011, -0.009) | 1.12 (1.11, 1.13) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.048 (-0.055, -0.041) | 1.79 (1.61, 1.96) | |
| SDOH-Q3 | -0.066 (-0.074, -0.058) | 2.25 (2.03, 2.50) | |
| SDOH-Q4 | -0.122 (-0.137, -0.107) | 3.73 (3.23, 4.30) | |
| Race/ethnicity | |||
| Non-Hispanic White | SDoH index* | -0.007 (-0.007, -0.007) | 1.12 (1.11, 1.13) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.027 (-0.031, -0.024) | 1.85 (1.70, 2.00) | |
| SDOH-Q3 | -0.043 (-0.046, -0.040) | 2.56 (2.38, 2.75) | |
| SDOH-Q4 | -0.094 (-0.099, -0.089) | 5.09 (4.67, 5.56) | |
| Non-Hispanic Black | SDoH index* | -0.007 (-0.007, -0.006) | 1.11 (1.10, 1.12) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.036 (-0.046, -0.026) | 2.05 (1.63, 2.60) | |
| SDOH-Q3 | -0.049 (-0.057, -0.042) | 2.68 (2.23, 3.21) | |
| SDOH-Q4 | -0.100 (-0.109, -0.091) | 5.41 (4.46, 6.57) | |
| Non-Hispanic Asian | SDoH index* | -0.006 (-0.007, -0.005) | 1.14 (1.11, 1.16) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.029 (-0.039, -0.019) | 1.58 (1.05, 2.38) | |
| SDOH-Q3 | -0.039 (-0.047, -0.031) | 3.19 (2.31, 4.39) | |
| SDOH-Q4 | -0.069 (-0.082, -0.056) | 5.02 (3.65, 6.90) | |
| Hispanic | SDoH index* | -0.004 (-0.005, -0.004) | 1.08 (1.07, 1.09) |
| SDOH-Q1 | Reference | Reference | |
| SDOH-Q2 | -0.023 (-0.033, -0.014) | 1.95 (1.44, 2.63) | |
| SDOH-Q3 | -0.034 (-0.041, -0.027) | 2.31 (1.80, 2.97) | |
| SDOH-Q4 | -0.064 (-0.070, -0.057) | 4.06 (3.21, 5.11) | |
* Estimate for 1-unit increase in cumulative SDoH index
Notes: HALex scores were assessed with two-part models. Poor HALex was assessed with logistic regression. Results of ‘Other’ race/ethnicity group not shown due to limited sample size
All models adjusted for age, sex, or race/ethnicity (where appropriate), smoking history, obesity, arthritis, cancer, chronic liver disease, coronary heart disease, COPD, diabetes, hypertension, kidney failure, stroke, Kessler-6 score, and US geographic region of residence
Abbreviations: β – beta coefficient; HALex – Health and Activity Limitation index; OR – odds ratio; SDoH-Q – quartile group of cumulative social determinants of health index