Table 5. Adjusted Mixed-Effects Logistic Regression With Social Risk Domains in Blocks for 2 or More Poorly Controlled CVD Risk Outcomesa.
| At least 2 poorly controlled CVD risks, OR (95% CI) | |||||
|---|---|---|---|---|---|
| Model 1b | Model 2c | Model 3d | Model 4e | Model 5f | |
| Economic stability | |||||
| Medication cost–related nonadherence | 1.31 (0.93-1.85) | 1.33 (0.94-1.87) | 1.24 (0.88-1.75) | 1.23 (0.87-1.74) | 1.22 (0.86-1.73) |
| Difficulty paying bills | 1.31 (0.79-2.18) | 1.32 (0.79-2.20) | 1.26 (0.75-2.10) | 1.24 (0.74-2.08) | 1.28 (0.77-2.14) |
| Financial hardship | 1.08 (0.62-1.88) | 1.07 (0.61-1.86) | 1.08 (0.62-1.89) | 1.08 (0.62-1.89) | 0.98 (0.56-1.72) |
| Lowest-quartile income or assets | 1.32 (1.02-1.70)a | 1.27 (0.98-1.65) | 1.25 (0.96-1.62) | 1.25 (0.96-1.62) | 1.19 (0.90-1.58) |
| Employment adversity | 0.95 (0.70-1.28) | 0.95 (0.70-1.28) | 0.94 (0.70-1.27) | 0.93 (0.69-1.26) | 0.84 (0.61-1.15) |
| Neighborhood or built environment | |||||
| Food insecurity | 0.80 (0.51-1.24) | 0.80 (0.51-1.24) | 0.81 (0.52-1.26) | 0.80 (0.51-1.25) | 0.78 (0.50-1.21) |
| Neighborhood physical disorder | 1.06 (0.79-1.44) | 1.05 (0.78-1.43) | 1.07 (0.78-1.44) | 1.05 (0.78-1.43) | 1.04 (0.76-1.41) |
| Lack of neighborhood social cohesion | 1.15 (0.85-1.55) | 1.14 (0.85-1.55) | 1.13 (0.83-1.53) | 1.12 (0.83-1.52) | 1.07 (0.79-1.45) |
| Adverse social support | 1.22 (0.96-1.55) | 1.22 (0.96-1.55) | 1.21 (0.96-1.54) | 1.17 (0.91-1.50) | 1.11 (0.86-1.42) |
| Education access | |||||
| Lack of education | NA | 1.18 (0.90-1.55) | 1.18 (0.90-1.54) | 1.18 (0.90-1.55) | 1.27 (0.95-1.68) |
| Health care access | |||||
| Lack of health insurance | NA | NA | 2.35 (1.74-3.18)a | 2.35 (1.74-3.18)a | 1.72 (1.26-2.37)a |
| Social or community context | |||||
| Depression | NA | NA | NA | 0.99 (0.73-1.33) | 1.11 (0.82-1.51) |
| Perceived everyday discrimination | NA | NA | NA | 1.18 (0.91-1.51) | 1.11 (0.86-1.44) |
| Covariates | |||||
| High blood pressure | NA | NA | NA | NA | 1.16 (0.87-1.53) |
| Cancer | NA | NA | NA | NA | 0.50 (0.34-0.74)a |
| Lung disease | NA | NA | NA | NA | 0.95 (0.66-1.36) |
| Heart disease | NA | NA | NA | NA | 1.09 (0.84-1.41) |
| Stroke | NA | NA | NA | NA | 0.83 (0.54-1.28) |
| Emotional or psychiatric problems | NA | NA | NA | NA | 0.80 (0.59-1.08) |
| Arthritis | NA | NA | NA | NA | 0.88 (0.69-1.13) |
| Dementia | NA | NA | NA | NA | 1.28 (0.50-3.31) |
| Age, y | |||||
| 60-74 | NA | NA | NA | NA | 0.64 (0.49-0.85)a |
| ≥75 | NA | NA | NA | NA | 0.41 (0.28-0.60)a |
| Race and ethnicityg | |||||
| Non-Hispanic Black | NA | NA | NA | NA | 1.27 (0.95-1.70) |
| Other | NA | NA | NA | NA | 1.15 (0.84-1.58) |
| Married or living with a partner | NA | NA | NA | NA | 0.93 (0.72-1.20) |
| Sex | |||||
| Male | NA | NA | NA | NA | 1 [Reference] |
| Female | NA | NA | NA | NA | 0.74 (0.58-0.94)a |
Abbreviations: CVD, cardiovascular disease; NA, not applicable; OR, odds ratio.
P < .05.
Model 1 included economic stability variables and neighborhood or built environment variables.
Model 2 included economic stability variables, neighborhood or built environment variables, and education access variables.
Model 3 included economic stability variables, neighborhood or built environment variables, education access variables, and health care access variables.
Model 4 included economic stability variables, neighborhood or built environment variables, education access variables, health care access variables, and social or community context variables.
Model 5 included economic stability variables, neighborhood or built environment variables, education access variables, health care access variables, social or community context variables, and covariates.
Race and ethnicity were self-identified by participants. Other race and ethnicity groups included American Indian and Alaska Native, Asian, Hispanic, and Native Hawaiian or Pacific Islander.