健康的不利社会决定因素与西班牙裔/拉丁裔成年人中风/短暂性脑缺血发作和血管风险因素的相关性：来自西班牙语社区健康研究/拉丁牙裔研究的结果。

IF 6 1区医学 Q1 CLINICAL NEUROLOGY

Journal of Stroke Pub Date : 2023-09-01 Epub Date: 2023-08-10 DOI:10.5853/jos.2023.00626

Gabriela Trifan, Linda C Gallo, Melissa Lamar, Olga Garcia-Bedoya, Krista M Perreira, Amber Pirzada, Gregory A Talavera, Sylvia W Smoller, Carmen R Isasi, Jianwen Cai, Martha L Daviglus, Fernando D Testai

{"title":"健康的不利社会决定因素与西班牙裔/拉丁裔成年人中风/短暂性脑缺血发作和血管风险因素的相关性：来自西班牙语社区健康研究/拉丁牙裔研究的结果。","authors":"Gabriela Trifan, Linda C Gallo, Melissa Lamar, Olga Garcia-Bedoya, Krista M Perreira, Amber Pirzada, Gregory A Talavera, Sylvia W Smoller, Carmen R Isasi, Jianwen Cai, Martha L Daviglus, Fernando D Testai","doi":"10.5853/jos.2023.00626","DOIUrl":null,"url":null,"abstract":"Background and purpose: Social determinants of health (SDOH) are non-medical factors that may contribute to the development of diseases, with a higher representation in underserved populations. Our objective is to determine the association of unfavorable SDOH with self-reported stroke/transient ischemic attack (TIA) and vascular risk factors (VRFs) among Hispanic/Latino adults living in the US.Methods: We used cross-sectional data from the Hispanic Community Health Study/Study of Latinos. SDOH and VRFs were assessed using questionnaires and validated scales and measurements. We investigated the association between the SDOH (individually and as count: ≤1, 2, 3, 4, or ≥5 SDOH), VRFs and stroke/TIA using regression analyses.Results: For individuals with stroke/TIA (n=388), the mean age (58.9 years) differed from those without stroke/TIA (n=11,210; 46.8 years; P<0.0001). In bivariate analysis, income <$20,000, education less than high school, no health insurance, perceived discrimination, 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 retained further. A higher number of SDOH was directly associated with all individual VRFs investigated, except for at-risk alcohol, and with number of VRFs (β=0.11, 95% confidence interval [CI]=0.09-0.14). In the fully adjusted model, income, discrimination, social support, chronic stress, and employment status were individually associated with stroke/TIA; the odds of stroke/TIA were 2.3 times higher in individuals with 3 SDOH (95% CI 1.6-3.2) and 2.7 times (95% CI 1.9-3.7) for those with ≥5 versus ≤1 SDOH.Conclusion: Among Hispanic/Latino adults, a higher number of SDOH is associated with increased odds for stroke/TIA and VRFs. The association remained significant after adjustment for VRFs, suggesting involvement of non-vascular mechanisms.","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"25 3","pages":"361-370"},"PeriodicalIF":6.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/7e/jos-2023-00626.PMC10574305.pdf","citationCount":"0","resultStr":"{\"title\":\"Association of Unfavorable Social Determinants of Health With Stroke/Transient Ischemic Attack and Vascular Risk Factors in Hispanic/Latino Adults: Results From Hispanic Community Health Study/Study of Latinos.\",\"authors\":\"Gabriela Trifan, Linda C Gallo, Melissa Lamar, Olga Garcia-Bedoya, Krista M Perreira, Amber Pirzada, Gregory A Talavera, Sylvia W Smoller, Carmen R Isasi, Jianwen Cai, Martha L Daviglus, Fernando D Testai\",\"doi\":\"10.5853/jos.2023.00626\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background and purpose: Social determinants of health (SDOH) are non-medical factors that may contribute to the development of diseases, with a higher representation in underserved populations. Our objective is to determine the association of unfavorable SDOH with self-reported stroke/transient ischemic attack (TIA) and vascular risk factors (VRFs) among Hispanic/Latino adults living in the US.Methods: We used cross-sectional data from the Hispanic Community Health Study/Study of Latinos. SDOH and VRFs were assessed using questionnaires and validated scales and measurements. We investigated the association between the SDOH (individually and as count: ≤1, 2, 3, 4, or ≥5 SDOH), VRFs and stroke/TIA using regression analyses.Results: For individuals with stroke/TIA (n=388), the mean age (58.9 years) differed from those without stroke/TIA (n=11,210; 46.8 years; P<0.0001). In bivariate analysis, income <$20,000, education less than high school, no health insurance, perceived discrimination, 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 retained further. A higher number of SDOH was directly associated with all individual VRFs investigated, except for at-risk alcohol, and with number of VRFs (β=0.11, 95% confidence interval [CI]=0.09-0.14). In the fully adjusted model, income, discrimination, social support, chronic stress, and employment status were individually associated with stroke/TIA; the odds of stroke/TIA were 2.3 times higher in individuals with 3 SDOH (95% CI 1.6-3.2) and 2.7 times (95% CI 1.9-3.7) for those with ≥5 versus ≤1 SDOH.Conclusion: Among Hispanic/Latino adults, a higher number of SDOH is associated with increased odds for stroke/TIA and VRFs. The association remained significant after adjustment for VRFs, suggesting involvement of non-vascular mechanisms.\",\"PeriodicalId\":17135,\"journal\":{\"name\":\"Journal of Stroke\",\"volume\":\"25 3\",\"pages\":\"361-370\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/7e/jos-2023-00626.PMC10574305.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Stroke\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5853/jos.2023.00626\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5853/jos.2023.00626","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景和目的：健康的社会决定因素（SDOH）是可能导致疾病发展的非医学因素，在服务不足的人群中有更高的代表性。我们的目的是确定居住在美国的西班牙裔/拉丁裔成年人中，不良SDOH与自我报告的中风/短暂性脑缺血发作（TIA）和血管危险因素（VRF）的关系。SDOH和VRF使用问卷和经验证的量表和测量进行评估。我们使用回归分析研究了SDOH（单独和计数：≤1、2、3、4或≥5 SDOH）、VRF与中风/TIA之间的相关性。结果：对于脑卒中/短暂性脑缺血发作患者（n=388），其平均年龄（58.9岁）与无脑卒中/暂时性脑缺血的患者（n=11210；46.8岁；P结论：在西班牙裔/拉丁裔成年人中，较高的SDOH与脑卒中/特发性脑缺血和VRF的几率增加有关。VRF调整后，这种关联仍然显著，表明涉及非血管机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Association of Unfavorable Social Determinants of Health With Stroke/Transient Ischemic Attack and Vascular Risk Factors in Hispanic/Latino Adults: Results From Hispanic Community Health Study/Study of Latinos.

查看原文本刊更多论文

Background and purpose: Social determinants of health (SDOH) are non-medical factors that may contribute to the development of diseases, with a higher representation in underserved populations. Our objective is to determine the association of unfavorable SDOH with self-reported stroke/transient ischemic attack (TIA) and vascular risk factors (VRFs) among Hispanic/Latino adults living in the US.

Methods: We used cross-sectional data from the Hispanic Community Health Study/Study of Latinos. SDOH and VRFs were assessed using questionnaires and validated scales and measurements. We investigated the association between the SDOH (individually and as count: ≤1, 2, 3, 4, or ≥5 SDOH), VRFs and stroke/TIA using regression analyses.

Results: For individuals with stroke/TIA (n=388), the mean age (58.9 years) differed from those without stroke/TIA (n=11,210; 46.8 years; P<0.0001). In bivariate analysis, income <$20,000, education less than high school, no health insurance, perceived discrimination, 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 retained further. A higher number of SDOH was directly associated with all individual VRFs investigated, except for at-risk alcohol, and with number of VRFs (β=0.11, 95% confidence interval [CI]=0.09-0.14). In the fully adjusted model, income, discrimination, social support, chronic stress, and employment status were individually associated with stroke/TIA; the odds of stroke/TIA were 2.3 times higher in individuals with 3 SDOH (95% CI 1.6-3.2) and 2.7 times (95% CI 1.9-3.7) for those with ≥5 versus ≤1 SDOH.

Conclusion: Among Hispanic/Latino adults, a higher number of SDOH is associated with increased odds for stroke/TIA and VRFs. The association remained significant after adjustment for VRFs, suggesting involvement of non-vascular mechanisms.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Stroke CLINICAL NEUROLOGYPERIPHERAL VASCULAR DISE-PERIPHERAL VASCULAR DISEASE

CiteScore

11.00

自引率

3.70%

发文量

审稿时长

12 weeks

期刊介绍： The Journal of Stroke (JoS) is a peer-reviewed publication that focuses on clinical and basic investigation of cerebral circulation and associated diseases in stroke-related fields. Its aim is to enhance patient management, education, clinical or experimental research, and professionalism. The journal covers various areas of stroke research, including pathophysiology, risk factors, symptomatology, imaging, treatment, and rehabilitation. Basic science research is included when it provides clinically relevant information. The JoS is particularly interested in studies that highlight characteristics of stroke in the Asian population, as they are underrepresented in the literature. The JoS had an impact factor of 8.2 in 2022 and aims to provide high-quality research papers to readers while maintaining a strong reputation. It is published three times a year, on the last day of January, May, and September. The online version of the journal is considered the main version as it includes all available content. Supplementary issues are occasionally published. The journal is indexed in various databases, including SCI(E), Pubmed, PubMed Central, Scopus, KoreaMed, Komci, Synapse, Science Central, Google Scholar, and DOI/Crossref. It is also the official journal of the Korean Stroke Society since 1999, with the abbreviated title J Stroke.