Abstract 15567: Associations Between Social Determinants of Health and Cardiovascular Health of Adult Cancer Survivors in the United States

Abstract

Background: Relationships between social determinants of health (SDOH) and cardiovascular health (CVH) of cancer survivors are underexplored. Aims: To investigate associations between SDOH and CVH of adult cancer survivors in the United States (US). Methods: Data from the US National Health Interview Survey (2013-2017) were used. Participants reporting a history of cancer were included, excluding those with only non-melanoma skin cancer, or with missing data for any domain of SDOH or CVH. SDOH was quantified with a six-domain, 38-item score consistent with the Centers for Disease Control and Prevention recommendations (higher score indicated worse deprivation). CVH was quantified based on the American Heart Association’s Life’s Essential 8. As detailed dietary data were unavailable, a seven-item CVH score was used (higher score indicated worse CVH). Survey-specific multivariable Poisson regression was used to test associations between SDOH quartiles and CVH. Results: Altogether, 8254 participants were analyzed, representing a weighted population of 10,887,989 persons. Worse SDOH was associated with worse CVH (highest vs. lowest quartile: risk ratio 1.30 [95% confidence interval 1.25, 1.35], p<0.001), with a grossly linear relationship between SDOH and CVH scores ( Figure 1A) . Subgroup analysis found significantly stronger associations in younger participants (p interaction =0.026) and females (p interaction =0.001), but without statistically significant interactions with race (p interaction =0.051) ( Figure 1B) . Higher scores in all domains of SDOH were independently associated with worse CVH (all p<0.001). Higher SDOH scores were also independently associated with the presence of all items of the CVH score (all p<0.05 for highest SDOH quartile). Conclusions: An unfavorable SDOH profile was independently associated with worse CVH among adult cancer survivors, with notably stronger associations in females and younger individuals.