ArticleJournal of health, population, and nutrition2025
Independent associations of social determinants of health with mortality and added predictive value beyond life's essential 8.
Article in Journal of health, population, and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Mortality risk estimation for autistic older adults: comparing novel machine-learning derived weights versus standard weights for the Charlson Comorbidity Index.Journal of comparative effectiveness research · 2026Article
- Social Determinants of Cardiovascular Health: Yes, They Matter-But What Can We Do to Address Them?Current cardiology reports · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundSocial Determinants of Health (SDoHs) exert their influence primarily through social structures and environmental conditions. However, limited evidence exists regarding which specific SDoHs are associated with all-cause and cardiovascular mortality, and whether incorporating SDoHs into the Life's Essential 8 (LE8) framework improves mortality prediction.
methodsData were analyzed from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). Weighted Cox proportional hazards models were used to estimate associations between SDoHs and mortality. Additive interaction effects were quantified using the relative excess risk due to interaction (RERI). Predictive performance was assessed using continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) for all-cause and cardiovascular mortality.
resultsAmong 22,938 participants, 2,344 all-cause deaths (7.29%) and 720 cardiovascular deaths (2.12%) were observed over a median follow-up of 7.83 years. Multivariable analyses revealed that unemployment (HR = 1.44, 95% CI: 1.25-1.66), low-income status (poverty-to-income ratio (PIR) < 1; HR = 1.75, 95% CI: 1.32-2.31), severe food insecurity (HR = 1.45, 95% CI: 1.19-1.78), and being unmarried or living alone (HR = 1.43, 95% CI: 1.28-1.59) were independent predictors of all-cause mortality (all P < 0.001). Low PIR (HR = 1.90, 95% CI: 1.21-2.97) and being unmarried or living alone (HR = 1.52, 95% CI: 1.26-1.85) were also significantly associated with cardiovascular mortality. Significant additive interactions were found between unemployment and low PIR (RERI = 0.90), food insecurity (RERI = 0.59), and unmarried or living alone (RERI = 0.37) for all-cause mortality. An additive interaction between low PIR and unmarried or living alone (RERI = 0.46) was observed for cardiovascular mortality. Including these SDoHs significantly improved 1-, 3-, 5-, and 10-year prediction of all-cause and cardiovascular mortality (NRI and IDI, all P < 0.05).
conclusionUnemployment, low PIR, severe food insecurity, and being unmarried or living alone were identified as independent predictors of increased all-cause mortality. Low PIR and being unmarried or living alone were also associated with cardiovascular mortality. Incorporating these SDoHs into the LE8 framework improved predictive performance for both mortality outcomes.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.