Evidence mapPaperPMID 39556532Full record

ArticlePloS one2024

Structural and social determinants of health: The multi-ethnic study of atherosclerosis.

Lilah M Besser, Sarah N Forrester, Milla Arabadjian, Michael P Bancks, Margaret Culkin, Kathleen M Hayden, Elaine T Le, Isabelle Pierre-Louis, Jana A Hirsch

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lilah M BesserDepartment of Neurology, Comprehensive Center for Brain Health, University of Miami, Boca Raton, Florida, United States of America.ORCID https://orcid.org/0000-0001-9945-0877
Sarah N ForresterDivision of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America.
Milla ArabadjianDepartment of Foundations of Medicine, NYU Grossman Long Island School of Medicine, Mineola, New York, United States of America.ORCID https://orcid.org/0000-0003-3307-1406
Michael P BancksDepartment of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America.ORCID https://orcid.org/0000-0003-3694-6060
Margaret CulkinDepartment of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America.
Kathleen M HaydenDepartment of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-7745-3513
Elaine T LeDepartment of Neurology, Comprehensive Center for Brain Health, University of Miami, Boca Raton, Florida, United States of America.
Isabelle Pierre-LouisDivision of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States of America.
Jana A HirschUrban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America.

Funding

Transdisciplinary Training In Cardiovascular ResearchT32HL120823 · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2025 to 2025
$428k
NHLBI NIH HHS T32 HL120823
6 · The paper itself

Abstract

backgroundResearchers have increasingly recognized the importance of structural and social determinants of health (SSDOH) as key drivers of a multitude of diseases and health outcomes. The Multi-Ethnic Study of Atherosclerosis (MESA) is an ongoing, longitudinal cohort study of subclinical cardiovascular disease (CVD) that has followed geographically and racially/ethnically diverse participants starting in 2000. Since its inception, MESA has incorporated numerous SSDOH assessments and instruments to study in relation to CVD and aging outcomes. In this paper, we describe the SSDOH data available in MESA, systematically review published papers using MESA that were focused on SSDOH and provide a roadmap for future SSDOH-related studies. METHODS AND

findingsThe study team reviewed all published papers using MESA data (n = 2,125) through January 23, 2023. Two individuals systematically reviewed titles, abstracts, and full text to determine the final number of papers (n = 431) that focused on at least one SSDOH variable as an exposure, outcome, or stratifying/effect modifier variable of main interest (discrepancies resolved by a third individual). Fifty-seven percent of the papers focused on racialized/ethnic groups or other macrosocial/structural factors (e.g., segregation), 16% focused on individual-level inequalities (e.g. income), 14% focused on the built environment (e.g., walking destinations), 10% focused on social context (e.g., neighborhood socioeconomic status), 34% focused on stressors (e.g., discrimination, air pollution), and 4% focused on social support/integration (e.g., social participation). Forty-seven (11%) of the papers combined MESA with other cohorts for cross-cohort comparisons and replication/validation (e.g., validating algorithms).

conclusionsOverall, MESA has made significant contributions to the field and the published literature, with 20% of its published papers focused on SSDOH. Future SSDOH studies using MESA would benefit by using recently added instruments/data (e.g., early life educational quality), linking SSDOH to biomarkers to determine underlying causal mechanisms linking SSDOH to CVD and aging outcomes, and by focusing on intersectionality, understudied SSDOH (i.e., social support, social context), and understudied outcomes in relation to SSDOH (i.e., sleep, respiratory health, cognition/dementia).

Indexed as

AtherosclerosisEthnicitySocial Determinants of HealthAgedAged, 80 and overFemaleHumansLongitudinal StudiesMaleMiddle AgedRisk FactorsSocioeconomic FactorsUnited States

Identifiers

PMID39556532
PMCPMC11573213

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.