Individual and cumulative effects of social determinants of health on cardiovascular disease: Gender-specific insights from a cross-sectional NHANES study

Xiuming Yang, Jiahui Zhou, Feier Wu, Zehu Xue and Zongliang Yu

PLOS ONE, 2026, vol. 21, issue 3, 1-15

Abstract: Objective: This study aimed to examine the associations of individual and cumulative social determinants of health (SDoH) with cardiovascular disease (CVD) prevalence and sex-specific disparities among U.S. adults. Methods: Employing a cross-sectional design, we analyzed data from the nationally representative National Health and Nutrition Examination Survey (NHANES, 2005–2018). Five core SDoH domains were operationalized through eight validated sub-indicators. Associations between individual and cumulative SDoH and CVD prevalence were assessed using survey-weighted multivariate logistic regression, with sex-stratified analyses. Results: In this cross-sectional sample of 35,781 participants, adverse individual SDoH and higher cumulative adverse SDoH were associated with higher odds of prevalent CVD. In the fully adjusted model (Model 2), unemployment showed a large association with prevalent CVD (AOR = 2.27, 95% CI: 2.01–2.57). In sex-stratified analyses, point estimates for some SDoH indicators were higher in women than in men, but 95% confidence intervals overlapped for many comparisons and sex-by-SDoH interaction tests were not statistically significant (all P for interaction > 0.05). Among individual SDoH indicators, unemployment and low income (PIR

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0344108

DOI: 10.1371/journal.pone.0344108

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