Table 1.
Stepwise Cox Regression to Select Social Determinants of Health for the Polysocial Score Among Older Adults Aged 65 and Above
| Social Determinants of Health | Stepwise Analysis* | p Value | Score | |
|---|---|---|---|---|
| Coefficient | HR (95% CI) | |||
| Education level | — | — | — | — |
| Less than high school | Ref. | Ref. | — | — |
| High school graduate | −0.73 | 0.48 (0.40–0.58) | <.001 | 7 |
| Postsecondary | −1.03 | 0.36 (0.29−0.45) | <.001 | 10 |
| Total household income (U.S. dollars, $)† | — | — | — | — |
| 0–20 749.28 | Ref. | Ref. | — | — |
| 20 749.28–36 032 | −0.32 | 0.73 (0.59−0.91) | <.001 | 3 |
| 36 032–64 264 | −0.59 | 0.56 (0.42−0.73) | <.001 | 5 |
| 64 264–471 757.2 | −0.62 | 0.54 (0.39−0.74) | <.001 | 6 |
| Housing type | — | — | — | — |
| Two-family house/duplex | Ref. | Ref. | — | — |
| Mobile house | −0.83 | 0.43 (0.28−0.68) | <.001 | 8 |
| Apartment/Condo/townhouse/3–4 family house | −0.29 | 0.74 (0.56−0.98) | .04 | 3 |
| One family house | −0.57 | 0.57 (0.45−0.72) | <.001 | 6 |
| Life insurance coverage | — | — | — | — |
| No | Ref. | Ref. | — | — |
| Yes | −0.26 | 0.77 (0.65−0.91) | .002 | 3 |
| Total wealth (U.S. dollars, $)‡ | — | — | — | — |
| 769 100–84 500 | Ref. | Ref. | — | — |
| 84 500–264 500 | −0.33 | 0.72 (0.58−0.89) | .003 | 3 |
| 264 500–616 000 | −0.35 | 0.71 (0.55−0.90) | .006 | 4 |
| 616 000–4 930 000 | −0.48 | 0.62 (0.46−0.84) | .002 | 5 |
| Employment status | — | — | — | — |
| Retired | Ref. | Ref. | — | — |
| Working | −0.45 | 0.64 (0.45−0.89) | .009 | 5 |
| Marital status | — | — | — | — |
| Widowed | Ref. | Ref. | — | — |
| Separated/divorced | −0.40 | 0.67 (0.51−0.88) | .004 | 4 |
| Married/Partnered | −0.08 | 0.92 (0.75−1.12) | .41 | 1 |
| Neighborhood social cohesion§ | — | — | — | — |
| 1.00−4.38 | Ref. | Ref. | — | — |
| 4.38−4.75 | −0.17 | 0.84 (0.65−1.08) | .17 | 2 |
| 4.75−5.75 | −0.18 | 0.83 (0.68−1.02) | .08 | 2 |
| 5.75−7.00 | −0.28 | 0.76 (0.61−0.94) | .01 | 3 |
Notes: *Forward stepwise analysis incrementally included the education level, total household income, housing type, life insurance coverage, total wealth, employment status, marital status, discrimination, and out-of-pocket medical expenditure.
†Total household income was a sum of participants’ and their spouses’ earnings, pensions and annuities, Supplemental Security Income, Social Security Disability Income, Social Security retirement income, unemployment and workers’ compensation, other government transfers, household capital income, and other income (26).
‡Total wealth was a sum of all wealth components less debt including the net value of the first and second residence, the net value of the real estate, the net value of vehicles, the net value of businesses, the net value of individual retirement arrangement, the net value of stocks and other investments, the net value of bonds, and the net value of all other savings (26).
§Neighborhood social cohesion was rated by 7 conditions of the neighborhood areas within a 20-minute walk or a mile: (i) feel part of this area; (ii) no vandalism and graffiti; (iii) people can be trusted; (iv) people are afraid of walking alone in the dark; (v) most people are friendly; (vi) this area is kept very clean; (vii) people help you if in trouble; and (viii) no vacant or deserted houses. Each condition was rated by a score ranging from 1 (worst) to 7 (best) and was summed and averaged to measure overall neighborhood social cohesion.