Abstract 16126: Cumulative Impact of Social Determinants of Health Risk Score on Obesity Among Young Adults in the United States

Abstract

Introduction: The growing prevalence of obesity has created a major burden on the health care system. To date, studies examining social determinants of obesity in adults have mostly focused on individual social determinants of health (SDOH) components. In this study, we explore the influence of cumulative SDOH on obesity among young adults (< 45) as compared with middle- aged (45-64) and elderly (≥ 65) populations in the US. Methods: We examined cross-sectional data on 164,696 adult participants from the National Health Interview Survey (2013-17). For each individual, the unfavorable SDOH risk factor was identified from 39 sub-components, stemming from 6 general domains (economic stability, neighborhood and physical environment, community and social context, food, education, and healthcare system access). Risk factors were then aggregated to develop a cumulative score, wherein individuals were divided into quartiles. Obesity was calculated from self-reported height and weight and defined as BMI ≥ 30 kg/m 2 . Adults with a BMI <18.5 kg/m 2 were excluded from the analysis. Results: The age-adjusted prevalence of obesity was 32.5%, which translates to 78 million US adults annually. A linear increase in the prevalence of age-adjusted obesity was noted with increasing unfavorable SDOH prevalence across all age groups. In the overall population, those with the worst (4 th quartile) vs best (1 st quartile) SDOH profile had 1.47 higher odds of being obese in adjusted models. There was evidence, however, of effect modification by age (p-value for interaction < 0.001), with a stronger association of unfavorable SDOH risk with obesity in the young (<45 years) as compared with middle age and elderly (Table). Conclusions: A higher burden of SDOH is more strongly associated with obesity in young adults. Estimating and understanding the impact of SDOH may have practical implications for informing effective interventions to combat early adulthood obesity and its ensuing complications.