Table 1.

Bivariate associations between SDOH and composite endpoint (myocardial infarction/stroke/cardiovascular death)

Healthy People 2030 domain	SDOH	HR (95% CI)	P value
Social and community context	Social isolation from friends/familya,b	1.33 (1.09–1.62)	0.004
	Social isolation from caregiversa,c	1.19 (1.04–1.36)	0.014
Education	Low education (<high school)a	1.32 (1.18–1.48)	<0.001
Economic stability	Low annual household income (<$35,000)a	1.57 (1.40–1.75)	<0.001
Neighborhood/built environment	Zip code level povertya,d	1.11 (1.00–1.24)	0.046
	Rural residence	1.02 (0.73–1.42)	0.899
Health and healthcare	Residence in HPSAa	1.09 (1.00–1.20)	0.065
	Lack of health insurancea	1.15 (0.94–1.42)	0.176
	Poor state public health infrastructuree	1.02 (0.93–1.13)	0.665

SDOH, social determinants of health; HR, hazard ratio; CI, confidence interval; HPSA, Health Professional Shortage Area.

^aP<0.20,

^bSocial isolation from friends/family defined as those who have 0 or 1 friend/family that they have seen in the past month,

^cSocial isolation from caregivers defined as participants who reported they had no one to care for them if they became ill,

^dZip code level poverty defined as residence in zip code with >25% of residents living below the federal poverty line,

^ePublic health infrastructure vulnerability includes nine states whose ranking had been in the bottom 20% for poor health infrastructure for greater than or equal to 80% of the time between 1993 and 2002.

The time period reflects the 10 years preceding when REasons for Geographic and Racial Differences in Stroke (REGARDS) baseline data collection started in 2003.