Abstract 10664: Association of Unfavorable Social Determinants of Health With Stroke/TIA and Vascular Risk Factors: Results From the Hispanic Community Health Study/Study of Latinos

Abstract

Introduction: Social Determinants of Health (SDOH) contribute to the development of diseases and disproportionally affect minoritized groups. There is a paucity of information describing the relationship between SDOH, stroke/TIA and vascular risk factors (VRFs) in Hispanics/Latinos. Hypothesis: Unfavorable SDOH are associated with self-reported stroke/TIA and with increased VRFs. Methods: Cross-sectional data from cohort study of Hispanic Community Health Study/Study of Latinos (2014-2017). SDOH were assessed using questionnaires and previously validated scales. VRFs were hypertension, diabetes mellitus, hypercholesterolemia, smoking, at-risk alcohol use, and obesity. We investigated the association between the SDOH (individually and as count) and stroke/TIA using weighted complex survey multivariable logistic and linear regression analyses. Results: For individuals with stroke/TIA (weighted n=388), the mean age (58.9, 95% CI=56.4-61.5) differed from those without stroke/TIA (weighted n=11,210; 46.8, 95% CI=46.3-47.4). In bivariate analysis, income <$20,000, education less than high school, no health insurance, perceived discrimination, not retired and not currently employed, upper tertile for chronic stress, and lower tertiles for social support and language- and social-based acculturation were associated with stroke/TIA and used in further analysis. Participants were grouped into 5 categories based on the distribution of SDOH (≤1, 2, 3, 4 and ≥5 SDOH). Increasing number of SDOH was directly associated with the odds of each individual VRFs investigated (except for at-risk alcohol) and VRF count (β=0.11, 95% CI=0.09-0.14). After adjustment for confounders, the odds of stroke/TIA increased 2.3 times in individuals with three SDOH (95% CI 1.6-3.2) and 2.7 times (95% CI 1.9-3.7) for those with ≥5 SDOH, compared to those with ≤1 SDOH. In final model, income, discrimination, social support, chronic stress, and employment status were individually associated with higher odds of stroke/TIA. Conclusions: Increased number of SDOH increased odds for stroke/TIA and VRFs. The association between SDOH and stroke/TIA remained significant after adjustment for VRFs, suggesting the participation of additional mechanisms of disease.