Table 1.
Age and Gender Adjusted Associations of Social Determinants of Health with Fatal Incident Coronary Heart Disease and Incident Nonfatal Myocardial Infarction
| Healthy People 2020 Domain | Social Determinants of Health | Incident Fatal CHD | Incident Nonfatal MI | ||
|---|---|---|---|---|---|
| HR (95% CI) |
p | HR (95% CI) |
p | ||
| Social and community context | Black race |
1.65
(1.37, 1.98) |
<0.001 | 0.95 (0.83, 1.09) |
0.463 |
| Social isolation (Saw no friends/family in the past month) |
1.38
(0.95, 2.01) |
0.093 | 1.09 (0.81, 1.46) |
0.587 | |
| Social isolation (Do not have anyone to care for you if you become ill or disabled) | 0.94 (0.71, 1.25) |
0.674 | 1.00 (0.82, 1.22) |
0.982 | |
| Education | Low education (< High school) |
2.10
(1.67, 2.63) |
<0.001 |
1.43
(1.19, 1.73) |
0.0002 |
| Economic stability | Low annual household income (<$35,000) |
1.91
(1.55, 2.36) |
<0.001 |
1.32
(1.15, 1.53) |
0.0001 |
| Neighborhood/ built environment | Zip code with high poverty (>25% residents living below Federal poverty line) |
1.34
(1.08, 1.66) |
0.009 | 1.00 (0.84, 1.18) |
0.971 |
| Health and healthcare | Residence in a Health Professional Shortage Area | 1.08 (0.90, 1.30) |
0.405 | 0.93 (0.81, 1.06) |
0.206 |
| Residence in a State with least public health infrastructure* |
1.21
(1.00, 1.55) |
0.005 | 1.06 (0.93, 1.21) |
0.398 | |
| Lack of health insurance |
1.41
(0.94, 2.13) |
0.100 |
1.35
(1.04, 1.76) |
0.026 | |
*
Public Health Infrastructure is calculated based on America’s Health Ranking data; see text.
Bolded SDOH had associations with p<0.10.