Social determinants of health contribute to higher CVD mortality rates in Black persons

Abstract: https://www.acpjournals.org/doi/10.7326/M23-0507

A study of more than 50,000 US adults suggests that social determinants of health are a major contributing factor to higher mortality rates from cardiovascular disease (CVD) in Black individuals compared to Whites. The findings are published in Annals of Internal Medicine.

CVD mortality is persistently higher in the Black population than in other racial/ethnic groups in the United States. Social determinants of health (SDOHs) have been associated with CVD risk factors and CVD events and mortality in epidemiologic studies. However, data are scarce on the complex relationship of social, behavioral, and metabolic risk factors with racial differences in CVD mortality in a large, nationally representative sample in the U.S. population.

Researchers from Tulane University conducted an observational study of 50,808 persons aged 20 years and older to examine the degree to which social, behavioral, and metabolic risk factors are associated with CVD mortality and the extent to which racial differences in CVD mortality persist after these factors are accounted for. The authors found that age- and sex-adjusted CVD mortality was significantly higher in Black participants than White participants. They also found that in addition to behavioral and metabolic risk factors, several social factors—including unemployment, lower family income, food insecurity, not owning a home, and not being married or living with a partner—were significantly associated with CVD mortality independently of established behavioral and metabolic risk factors. Black–White differences in CVD mortality were diminished after adjustment for behavioral and metabolic risk factors and entirely dissipated after adjustment for social factors. According to the authors, future research is warranted to understand the underlying mechanisms of SDOHs on CVD mortality and develop novel interventions for reducing CVD mortality in populations, especially in Black persons.

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with the corresponding author Jiang He, MD, PhD, please contact Andrew Yawn at [email protected].