Evidence-based Linkages of SDoH to Health Outcomes – Part 2
A study titled, “Association of Social and Behavioral Risk Factors With Earlier Onset of Adult Hypertension and Diabetes” found cumulative social and behavioral risk was significantly associated with earlier onset of hypertension and diabetes.
1) Controlling for age, sex, race/ethnicity, body mass index, and survey year, people with 3 or more risk factors were 41% more likely to develop hypertension compared with those with 0 risk factors.
2) Controlling for age, sex, race/ethnicity, body mass index, and survey year, people with 3 or more risk factors were 53% more likely to develop hypertension compared with those with 0 risk factors.
Based on the individual determinants of hypertension and diabetes in rank order of increased hazard ratio, this study demonstrates that education level is a far more prevalent determinant to both hypertension and diabetes than unhealthy behaviors such as smoking and infrequent exercise.
While these risk factors do not stand alone, and other, seemingly important factors such as dietary habits and access to healthy food were not considered, the study identifies the significant role of social exposures in determining the onset of hypertension and diabetes.
Evidence-based Linkages of SDoH to Health Outcomes – Part 1
There is currently no consensus in the research on the magnitude of the relative contributions of each of these factors to health, and the purpose of this series is to highlight studies that suggest that health behaviors, such as smoking, diet, exercise, and social and economic factors are the primary drivers of actual health outcomes.
The study found that three social determinants emerged as being significantly related to the onset of chronic conditions for men:
1) Living in a more economically advantaged area was associated with a lower odds (-20%) of experiencing the onset of diabetes,
2) Living in areas with a higher immigrant concentration was associated with an increased odds (+16%) of developing high blood pressure, and
3) Living in an area with higher levels of crime and more segregation was associated with a higher odds (+18%) of developing cancer.