Evidence map›Paper›PMID 41790796›Full record

ArticlePloS one2026

Social determinants of healthy aging: An investigation using the all of us cohort.

Wei-Han Chen, Yao-An Lee, Huilin Tang, Chenyu Li, Ying Lu, Yu Huang, Rui Yin, Melissa J Armstrong, Yang Yang, Gregor Štiglic and 2 more

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Wei-Han ChenDepartment of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida, United States of America.ORCID https://orcid.org/0000-0001-8545-6127
Yao-An LeeRegenstrief Institute, Indianapolis, Indiana, United States of America.
Huilin TangDepartment of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida, United States of America.
Chenyu LiDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0001-7434-6571
Ying LuDepartment of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida, United States of America.
Yu HuangDepartment of Health Outcomes and Bioinformatics, University of Florida, Gainesville, Florida, United States of America.ORCID https://orcid.org/0000-0001-7373-4716
Rui YinDepartment of Health Outcomes and Bioinformatics, University of Florida, Gainesville, Florida, United States of America.
Melissa J ArmstrongNorman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida, United States of America.ORCID https://orcid.org/0000-0002-2163-1907
Yang YangDatabricks Inc., San Francisco, California, United States of America.
Gregor ŠtiglicFaculty of Health Sciences, University of Maribor, Maribor, Slovenia.
Jiang BianRegenstrief Institute, Indianapolis, Indiana, United States of America.
Jingchuan GuoDepartment of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida, United States of America.ORCID https://orcid.org/0000-0001-9799-2592

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe increasing aging population raises significant concerns about the ability of individuals to age healthily, avoiding chronic diseases and maintaining cognitive and physical functions. However, the pathways through which SDOH factors are associated with healthy aging remain unclear.

methodsThis retrospective cohort study uses the registered tier data from the All of Us Research Program (AoURP) registered tier dataset v7. Eligible study participants are those aged 50 and older who have responded to any of the SDOH survey questions with available EHR data. Three different algorithms were trained (logistic regression [LR], multi-layer perceptron [MLP], and extreme gradient boosting [XGBoost]). The outcome is healthy aging, which is measured by a composite score of the status for 1) comorbidities, 2) cognitive conditions, and 3) mobility function. We evaluate the model performance by area under the receiver operating characteristic curve (AUROC) and assess the fairness of best-performed model through predictive parity. Feature importance is analyzed using SHapley Additive exPlanations (SHAP) values.

resultsOur study included 99,935 participants aged 50 and above, and the mean (SD) age was 74 (9.3), with 55,294 (55.3%) females, 67,457 (67.5%) Whites, 11,109 (11.1%) Hispanic ethnicity, and 44,109 (44.1%) are classified as healthy aging. Most of the individuals lived in their own house (64%), were married (51%), obtained college or advanced degrees (74%), and had Medicare (56.2%). The best predictive model was XGBoost with random oversampler, with a performance of AUROC [95% CI]: 0.793 [0.788-0.796], F1 score: 0.697 [0.692-0.701], recall: 0.739 [0.732-0.748], precision: 0.659 [0.655-0.663], and accuracy: 0.716 [0.712-0.720], and the XGBoost model achieved predictive parity by similar positive and negative predictive values across race and sex groups (0.86-1.06). In feature importance analysis, health insurance type is ranked as the most predictive feature, followed by employment status, substance use, and health insurance coverage (yes/no).

conclusionIn this cohort study, XGBoost model accurately predicted individuals achieving healthy aging, outperforming LR and MLP. Our findings underscore the significant role of health insurance in contributing to healthy aging.

Indexed as

Healthy AgingSocial Determinants of HealthAgedAged, 80 and overBoosting Machine Learning AlgorithmsFemaleHumansLogistic ModelsMaleMiddle AgedRetrospective StudiesROC CurveUnited States

Identifiers

PMID41790796
PMCPMC12965612

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.