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Cited by 96Health disparities and outcomesCardiovascular Health and Risk FactorsPublic Health and Social Inequalities

Neighborhood-level Social Vulnerability and Prevalence of Cardiovascular Risk Factors and Coronary Heart Disease

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Bevan, Graham, Pandey, Ambarish, Griggs, Stephanie, Dalton, Jarrod E., Zidar, David, Patel, Shivani, Khan, Safi U, Nasir, Khurram +2 more·2023·Current Problems in Cardiology
DOI 10.1016/j.cpcardiol.2022.101182PMC PMC9875801
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Abstract

Social determinants of health are implicated in the geographic variation in cardiovascular diseases (CVDs). The social vulnerability index (SVI) is an estimate of a neighborhood's potential for deleterious outcomes when faced with natural disasters or disease outbreaks. We sought to investigate the association of the SVI with cardiovascular risk factors and the prevalence of coronary heart disease (CHD) in the United States at the census tract level. We linked census tract SVI with prevalence of census tract CVD risk factors (smoking, high cholesterol, diabetes, high blood pressure, low physical activity and obesity), and prevalence of CHD obtained from the behavioral risk factor surveillance system. We evaluated the association between SVI, its sub-scales, CVD risk factors and CHD prevalence using linear regression. Among 72,173 census tracts, prevalence of all cardiovascular risk factors increased linearly with SVI. A higher SVI was associated with a higher CHD prevalence (R 2 = 0.17, P < 0.0001). The relationship between SVI and CHD was stronger when accounting for census-tract median age (R 2 = 0.57, P < 0.0001). A multivariable linear regression model including 4 SVI themes separately explained considerably more variation in CHD prevalence than the composite SVI alone (50.0% vs 17.3%). Socioeconomic status and household composition and disability were the SVI themes most closely associated with cardiovascular risk factors and CHD prevalence. In the United States, social vulnerability can explain significant portion of geographic variation in CHD, and its risk factors. Neighborhoods with high social vulnerability are at disproportionately increased risk of CHD and its risk factors. Social determinants of health are implicated in the geographic variation in cardiovascular diseases (CVDs). We investigated the association of social vulnerability index (SVI) with cardiovascular risk factors and the prevalence of coronary heart disease (CHD) in the United States at the census tract level. We show that cardiovascular risk factors and CHD were more common with higher SVI. A multivariable linear regression model including 4 SVI themes separately explained considerably more variation in CHD prevalence than the composite SVI alone (50.0% vs 17.3%). Socioeconomic status and household composition and/or disability were the SVI themes most closely associated with cardiovascular risk factors and CHD prevalence.

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Authors
Bevan, G., Pandey, A., Griggs, S., Dalton, J. E., Zidar, D., Patel, S., Khan, S. U., Nasir, K., Rajagopalan, S., & Al-Kindi, S.
Affiliations
  • University Hospitals of Cleveland (US)
  • The University of Texas Southwestern Medical Center (US)
  • Case Western Reserve University (US)
  • Cleveland Clinic (US)
  • Emory University (US)
  • Houston Methodist (US)
Corresponding author
Al-Kindi, Sadeer
ORCID
Venue
Current Problems in Cardiology
Publisher
Elsevier BV
Published
2023-08
Volume
48
Issue
8
Pages
101182
ISSN
0146-2806 (ISSN-L)
DOI
10.1016/j.cpcardiol.2022.101182
PMC
PMC9875801
OpenAlex
W4220801529
Cited by
96
References
2
Citations by year
2026: 14 · 2025: 24 · 2024: 33 · 2023: 22 · 2022: 3
FWCI
15.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Current Problems in Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Minority Health and Health Disparities (P50MD017351)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Social Sciences › Health › Public Health and Social Inequalities
Keywords
Social Vulnerability Index, social determinants of health, coronary artery disease, cardiovascular risk factors, socioeconomic status, household composition, disability, census tracts, smoking, diabetes mellitus, obesity, physical inactivity, hypertension, hypercholesterolemia
MeSH terms
Heart Disease Risk Factors, Social Vulnerability, Cardiovascular Diseases, Coronary Disease, Humans, Risk Factors, United States, Prevalence

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