Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study
Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communiti...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.024414 |
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| author | Vardhmaan Jain Mahmoud Al Rifai Safi U. Khan Ankur Kalra Fatima Rodriguez Zainab Samad Yashashwi Pokharel Arunima Misra Laurence S. Sperling Jamal S. Rana Waqas Ullah Ankit Medhekar Salim S. Virani |
| author_facet | Vardhmaan Jain Mahmoud Al Rifai Safi U. Khan Ankur Kalra Fatima Rodriguez Zainab Samad Yashashwi Pokharel Arunima Misra Laurence S. Sperling Jamal S. Rana Waqas Ullah Ankit Medhekar Salim S. Virani |
| author_sort | Vardhmaan Jain |
| collection | DOAJ |
| description | Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and household composition. We sought to assess the association of SVI with self‐reported prevalent cardiovascular comorbidities and atherosclerotic cardiovascular disease (ASCVD). Methods and Results We performed a retrospective cohort analysis of adults (≥18 years) in the Behavioral Risk Factor Surveillance System 2016 to 2019. Data regarding self‐reported prevalent cardiovascular comorbidities (including diabetes, hypertension, hyperlipidemia, smoking, substance use), and ASCVD was captured using participants' response to a structured telephonic interview. We divided states on the basis of the tertile of SVI (first—participant lives in the least vulnerable group of states, 0–0.32; to third—participant lives in the most vulnerable group of states, 0.54–1.0). Multivariable logistic regression models adjusting for age, race and ethnicity, sex, employment, income, health care coverage, and association with federal poverty line were constructed to assess the association of SVI with cardiovascular comorbidities. Our study sample consisted of 1 745 999 participants ≥18 years of age. States in the highest (third) tertile of social vulnerability had predominantly Black and Hispanic adults, lower levels of education, lower income, higher rates of unemployment, and higher rates of prevalent comorbidities including hypertension, diabetes, chronic kidney disease, hyperlipidemia, substance use, and ASCVD. In multivariable logistic regression models, individuals living in states in the third tertile of SVI had higher odds of having hypertension (odds ratio (OR), 1.14 [95% CI, 1.11–1.17]), diabetes (OR, 1.12 [95% CI, 1.09–1.15]), hyperlipidemia (OR, 1.09 [95% CI, 1.06–1.12]), chronic kidney disease (OR, 1.17 [95% CI, 1.12–1.23]), smoking (OR, 1.05 [95% CI, 1.03–1.07]), and ASCVD (OR, 1.15 [95% CI, 1.12–1.19]), compared with those living in the first tertile of SVI. Conclusions SVI varies across the US states and is associated with prevalent cardiovascular comorbidities and ASCVD, independent of age, race and ethnicity, sex, employment, income, and health care coverage. SVI may be a useful assessment tool for health policy makers and health systems researchers examining multilevel influences on cardiovascular‐related health behaviors and identifying communities for targeted interventions pertaining to social determinants of health. |
| first_indexed | 2024-04-09T23:23:27Z |
| format | Article |
| id | doaj.art-da908a89a72c4657b69b6152bc156854 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T23:23:27Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-da908a89a72c4657b69b6152bc1568542023-03-21T11:37:26ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-08-01111510.1161/JAHA.121.024414Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System StudyVardhmaan Jain0Mahmoud Al Rifai1Safi U. Khan2Ankur Kalra3Fatima Rodriguez4Zainab Samad5Yashashwi Pokharel6Arunima Misra7Laurence S. Sperling8Jamal S. Rana9Waqas Ullah10Ankit Medhekar11Salim S. Virani12Department of Internal Medicine Cleveland Clinic Foundation Cleveland OHSection of Cardiology and Cardiovascular Research, Department of Medicine Baylor College of Medicine Houston TXDepartment of Cardiology Houston Methodist DeBakey Heart & Vascular Center Houston TXDivision of Cardiovascular Medicine, Krannert Cardiovascular Research Center Indiana University School of Medicine Indianapolis INDivision of Cardiovascular Medicine and the Cardiovascular Institute Stanford University School of Medicine Stanford CADepartment of Cardiovascular Medicine Aga Khan University Karachi PakistanSection of Cardiovascular Medicine, Department of Medicine Wake Forest Baptist Health Winston‐Salem NCSection of Cardiology and Cardiovascular Research, Department of Medicine Baylor College of Medicine Houston TXDivision of Cardiovascular Medicine Emory University School of Medicine Atlanta GADivision of Cardiovascular Medicine Kaiser Permanente Oakland Medical Center Oakland CADivision of Cardiovascular Medicine Thomas Jefferson University Hospital Philadelphia PASection of Cardiology and Cardiovascular Research, Department of Medicine Baylor College of Medicine Houston TXSection of Cardiology and Cardiovascular Research, Department of Medicine Baylor College of Medicine Houston TXBackground Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and household composition. We sought to assess the association of SVI with self‐reported prevalent cardiovascular comorbidities and atherosclerotic cardiovascular disease (ASCVD). Methods and Results We performed a retrospective cohort analysis of adults (≥18 years) in the Behavioral Risk Factor Surveillance System 2016 to 2019. Data regarding self‐reported prevalent cardiovascular comorbidities (including diabetes, hypertension, hyperlipidemia, smoking, substance use), and ASCVD was captured using participants' response to a structured telephonic interview. We divided states on the basis of the tertile of SVI (first—participant lives in the least vulnerable group of states, 0–0.32; to third—participant lives in the most vulnerable group of states, 0.54–1.0). Multivariable logistic regression models adjusting for age, race and ethnicity, sex, employment, income, health care coverage, and association with federal poverty line were constructed to assess the association of SVI with cardiovascular comorbidities. Our study sample consisted of 1 745 999 participants ≥18 years of age. States in the highest (third) tertile of social vulnerability had predominantly Black and Hispanic adults, lower levels of education, lower income, higher rates of unemployment, and higher rates of prevalent comorbidities including hypertension, diabetes, chronic kidney disease, hyperlipidemia, substance use, and ASCVD. In multivariable logistic regression models, individuals living in states in the third tertile of SVI had higher odds of having hypertension (odds ratio (OR), 1.14 [95% CI, 1.11–1.17]), diabetes (OR, 1.12 [95% CI, 1.09–1.15]), hyperlipidemia (OR, 1.09 [95% CI, 1.06–1.12]), chronic kidney disease (OR, 1.17 [95% CI, 1.12–1.23]), smoking (OR, 1.05 [95% CI, 1.03–1.07]), and ASCVD (OR, 1.15 [95% CI, 1.12–1.19]), compared with those living in the first tertile of SVI. Conclusions SVI varies across the US states and is associated with prevalent cardiovascular comorbidities and ASCVD, independent of age, race and ethnicity, sex, employment, income, and health care coverage. SVI may be a useful assessment tool for health policy makers and health systems researchers examining multilevel influences on cardiovascular‐related health behaviors and identifying communities for targeted interventions pertaining to social determinants of health.https://www.ahajournals.org/doi/10.1161/JAHA.121.024414cardiovascular diseaserisk factorssocial vulnerabilitySVI |
| spellingShingle | Vardhmaan Jain Mahmoud Al Rifai Safi U. Khan Ankur Kalra Fatima Rodriguez Zainab Samad Yashashwi Pokharel Arunima Misra Laurence S. Sperling Jamal S. Rana Waqas Ullah Ankit Medhekar Salim S. Virani Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular disease risk factors social vulnerability SVI |
| title | Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study |
| title_full | Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study |
| title_fullStr | Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study |
| title_full_unstemmed | Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study |
| title_short | Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study |
| title_sort | association between social vulnerability index and cardiovascular disease a behavioral risk factor surveillance system study |
| topic | cardiovascular disease risk factors social vulnerability SVI |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.024414 |
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