Associations Between Health-Related Social Needs and Cardiovascular Health Among US Adults

Unfavorable health-related social needs (HRSNs) have the potential to worsen health and well-being and drive health disparities. Its associations with cardiovascular health (CVH), assessed by Life's Essential 8, have not been comprehensively examined among US adults.

We used the National Health and Nutrition Examination Survey 2011 to March 2020 data for adults aged ≥20 years. We grouped Life's Essential 8 scores as low (0-49), moderate (50-79), and high (80-100) CVH. We identified 8 unfavorable HRSNs and assigned a value of 1 for the unfavorable status of each. The number of unfavorable HRSNs was summed and ranged from 0 to 8, with higher numbers indicating more unfavorable HRSNs. We used multivariable linear and multinomial logistic regression to examine the association between HRSNs and CVH. A total of 14 947 participants were included (n=7340 male [49.3%]; mean [SE] age, 46.4 [0.35] years). A higher number of unfavorable HRSNs were associated with worse CVH: comparing adults with unfavorable HRSNs of 1-2, 3-4, and ≥5 to those with none, the fully adjusted prevalence ratios (95% CI) for low CVH were 1.42 (1.17-1.73), 2.11 (1.69-2.63), and 2.42 (1.90-3.08), respectively. The corresponding prevalence ratios (95% CI) for high CVH were 0.77 (0.68-0.87), 0.58 (0.49-0.67), and 0.46 (0.38-0.55). The associations were consistent across subgroups and in sensitivity analyses.

There was a graded association between unfavorable HRSNs and a higher prevalence of low CVH or lower prevalence of high CVH. Public health interventions targeting HRSNs might reduce health disparities and promote CVH.