The Impact of Clusters With Distinct Social Determinants by a Two-Step Cluster Analysis on Cardiovascular Health

The prevalence and mortality rates of cardiovascular diseases have been consistently high over the past 10 years in Ulsan, South Korea. Given the importance of social determinants in cardiovascular health, it is imperative to determine clusters with social determinants by a cluster analysis and their relationships with cardiovascular health.

The aims of this study were to identity clusters with distinct social determinants and to compare cardiovascular health among the identified clusters.

Social determinants (age, sex, job, education, monthly income, living location, medical institution usage, and experience of public resources), awareness and knowledge of stroke and myocardial infarction warning symptoms, health behaviors, and current history of hypertension, diabetes, and dyslipidemia were obtained from 1224 adults dwelling in Ulsan. A two-step cluster analysis, χ 2 test, and logistic regressions were used for data analysis.

Three clusters were identified and named "middle-aged male workers" (n = 379, 31.0%), "young professionals" (n = 482, 39.4%), and "older female dependents" (n = 363, 29.7%). Among the 3 clusters, there were significant differences in self-reported awareness of stroke and myocardial infarction warning symptoms, smoking, alcohol consumption, and eating habits related to salt intake (all P s ≤ .001). In logistic regressions, "middle-aged male workers" versus "young professionals" had an odds ratio of 6.41 ( P  < .001) for hypertension and a 6.30 for diabetes ( P  < .001), whereas odds ratios for "older female dependents" versus "young professionals" were 10.23 for hypertension ( P  < .001), 7.64 for diabetes ( P  < .001), and 5.04 for dyslipidemia ( P  < .001).

Understanding subgroups vulnerable to cardiovascular health with distinct social determinants should be prioritized, and on the basis of this, a public health promotion program is warranted.