Untangling the Complex Multidimensionality of the Social Determinants of Cardiovascular Health: A Systematic Review

Area of Science:

• Cardiovascular Medicine
• Public Health
• Health Services Research

Background:

• Lack of consensus exists on optimal metrics for reporting social determinants of health (SDH) or social deprivation in cardiovascular literature.
• The reporting of SDH as a single metric versus individual domains remains debated.

Approach:

• A systematic review of 47 studies (2010-2023) examined the relationship between SDH/social deprivation and health outcomes after cardiovascular procedures.
• Focus was on coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), valve surgery, and transcatheter aortic valve intervention.

Key Points:

• A wide variety of SDH/social deprivation metrics (41 different metrics) were used across studies.
• Despite metric heterogeneity, a consistent association was found between higher SDH/deprivation and worse cardiovascular outcomes.
• Only 9 studies reported on individual SDH domains, with 3 showing discordant relationships.

Conclusions:

• Substantial heterogeneity exists in SDH metric selection and reporting within cardiovascular disease research.
• Standardization of SDH metrics and reporting best practices is crucial for advancing cardiovascular research and patient care.