{"doi":"10.1001/jamanetworkopen.2024.37492","title":"Social Risk Factor Domains and Preventive Care Services in US Adults","abstract":"<jats:sec id=\"ab-zoi241092-4\"><jats:title>Importance</jats:title><jats:p>Growing evidence suggests that social determinants of health are associated with low uptake of preventive care services.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-5\"><jats:title>Objective</jats:title><jats:p>To examine the independent associations of social risk factor domains with preventive care services among US adults.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-6\"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This cross-sectional study used National Health Interview Survey data on 82 432 unweighted individuals (239 055 950 weighted) from 2016 to 2018. Subpopulations were created for each of the primary outcomes: routine mammography (women aged 40-74 years), Papanicolaou test (women aged 21-65 years), colonoscopy (adults aged 45-75 years), influenza vaccine (adults aged ≥18 years), and pneumococcal vaccine (adults aged ≥65 years). Statistical analysis was performed from July to December 2023.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-7\"><jats:title>Exposures</jats:title><jats:p>Six social risk domains (economic instability, lack of community, education deficit, food insecurity, social isolation, and lack of access to care) and a count of domains.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-8\"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Logistic regression models were used to examine the independent association between each primary outcome (mammography, Papanicolaou test, colonoscopy, influenza vaccine, and pneumococcal vaccine) and social risk factor domains, while controlling for covariates (age, sex, race and ethnicity, health insurance, and comorbidities).</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-9\"><jats:title>Results</jats:title><jats:p>A total of 82 432 unweighted US individuals (239 055 950 weighted individuals) were analyzed. A total of 54.3% were younger than 50 years, and 51.7% were female. All 5 screening outcomes were associated with educational deficit (mammography: odds ratio [OR], 0.73 [95% CI, 0.67-0.80]; Papanicolaou test: OR, 0.78 [95% CI, 0.72-0.85]; influenza vaccine: OR, 0.71 [95% CI, 0.67-0.74]; pneumococcal vaccine: OR, 0.68 [95% CI, 0.63-0.75]; colonoscopy: OR, 0.82 [95% CI, 0.77-0.87]) and a lack of access to care (mammography: OR, 0.32 [95% CI, 0.27-0.38]; Papanicolaou test: OR, 0.49 [95% CI, 0.44-0.54]; influenza vaccine: OR, 0.44 [95% CI, 0.41-0.47]; pneumococcal vaccine: OR, 0.30 [95% CI, 0.25-0.38]; colonoscopy: OR, 0.35 [95% CI, 0.30-0.41]). Fully adjusted models showed that every unit increase in social risk count was significantly associated with decreased odds of receiving a mammography (OR, 0.74 [95% CI, 0.71-0.77]), Papanicolaou test (OR, 0.84 [95% CI, 0.81-0.87]), influenza vaccine (OR, 0.81 [95% CI, 0.80-0.83]), pneumococcal vaccine (OR, 0.80 [95% CI, 0.77-0.83]), and colonoscopy (OR, 0.88 [95% CI, 0.86-0.90]).</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-10\"><jats:title>Conclusions and Relevance</jats:title><jats:p>This cross-sectional study of US adults suggests that social risk factor domains were associated with decreased odds of receiving preventive services; this association was cumulative. There is a need to address social risk factors to optimize receipt of recommended preventive services.</jats:p></jats:sec>","journal":"JAMA Network Open","year":2024,"id":648839,"datarank":0.6493984377447645,"base_score":2.772588722239781,"endowment":2.772588722239781,"self_citation_contribution":0.41588830833596724,"citation_network_contribution":0.23351012940879723,"self_endowment_contribution":0.41588830833596724,"citer_contribution":0.23351012940879723,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":13,"citers_with_citation_signal":7,"citers_with_endowment":7,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":736976,"name":"Mukoso N. Ozieh","orcid":"0000-0002-1017-611X","position":1,"is_corresponding":false},{"id":725543,"name":"Abigail Thorgerson","orcid":"0000-0002-6109-6785","position":2,"is_corresponding":false},{"id":756916,"name":"Joni S. Williams","orcid":"0000-0001-8988-3556","position":3,"is_corresponding":false},{"id":343878,"name":"Rebekah J. Walker","orcid":"0000-0002-7773-557X","position":4,"is_corresponding":false},{"id":343881,"name":"Leonard E. Egede","orcid":"0000-0003-1546-1515","position":5,"is_corresponding":false},{"id":1691177,"name":"Tamara Schroeder","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Social Risk Factor Domains and Preventive Care Services in US Adults","abstract":"<jats:sec id=\"ab-zoi241092-4\"><jats:title>Importance</jats:title><jats:p>Growing evidence suggests that social determinants of health are associated with low uptake of preventive care services.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-5\"><jats:title>Objective</jats:title><jats:p>To examine the independent associations of social risk factor domains with preventive care services among US adults.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-6\"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This cross-sectional study used National Health Interview Survey data on 82 432 unweighted individuals (239 055 950 weighted) from 2016 to 2018. Subpopulations were created for each of the primary outcomes: routine mammography (women aged 40-74 years), Papanicolaou test (women aged 21-65 years), colonoscopy (adults aged 45-75 years), influenza vaccine (adults aged ≥18 years), and pneumococcal vaccine (adults aged ≥65 years). Statistical analysis was performed from July to December 2023.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-7\"><jats:title>Exposures</jats:title><jats:p>Six social risk domains (economic instability, lack of community, education deficit, food insecurity, social isolation, and lack of access to care) and a count of domains.</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-8\"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Logistic regression models were used to examine the independent association between each primary outcome (mammography, Papanicolaou test, colonoscopy, influenza vaccine, and pneumococcal vaccine) and social risk factor domains, while controlling for covariates (age, sex, race and ethnicity, health insurance, and comorbidities).</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-9\"><jats:title>Results</jats:title><jats:p>A total of 82 432 unweighted US individuals (239 055 950 weighted individuals) were analyzed. A total of 54.3% were younger than 50 years, and 51.7% were female. All 5 screening outcomes were associated with educational deficit (mammography: odds ratio [OR], 0.73 [95% CI, 0.67-0.80]; Papanicolaou test: OR, 0.78 [95% CI, 0.72-0.85]; influenza vaccine: OR, 0.71 [95% CI, 0.67-0.74]; pneumococcal vaccine: OR, 0.68 [95% CI, 0.63-0.75]; colonoscopy: OR, 0.82 [95% CI, 0.77-0.87]) and a lack of access to care (mammography: OR, 0.32 [95% CI, 0.27-0.38]; Papanicolaou test: OR, 0.49 [95% CI, 0.44-0.54]; influenza vaccine: OR, 0.44 [95% CI, 0.41-0.47]; pneumococcal vaccine: OR, 0.30 [95% CI, 0.25-0.38]; colonoscopy: OR, 0.35 [95% CI, 0.30-0.41]). Fully adjusted models showed that every unit increase in social risk count was significantly associated with decreased odds of receiving a mammography (OR, 0.74 [95% CI, 0.71-0.77]), Papanicolaou test (OR, 0.84 [95% CI, 0.81-0.87]), influenza vaccine (OR, 0.81 [95% CI, 0.80-0.83]), pneumococcal vaccine (OR, 0.80 [95% CI, 0.77-0.83]), and colonoscopy (OR, 0.88 [95% CI, 0.86-0.90]).</jats:p></jats:sec><jats:sec id=\"ab-zoi241092-10\"><jats:title>Conclusions and Relevance</jats:title><jats:p>This cross-sectional study of US adults suggests that social risk factor domains were associated with decreased odds of receiving preventive services; this association was cumulative. There is a need to address social risk factors to optimize receipt of recommended preventive services.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":2.772588722239781,"endowment":2.772588722239781,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39365580","pmcid":"PMC11452812","openalex_id":"https://openalex.org/W4403114325","authors":[],"funders":[{"funder_name":"NIMHD NIH HHS","grant_id":"R01 MD017574","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"R01 DK120861","title":null},{"funder_name":"NIMHD NIH HHS","grant_id":"R01 MD013826","title":null},{"funder_name":"NIMHD NIH HHS","grant_id":"R01 MD018012","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"R21 DK131356","title":null},{"funder_name":"NIMHD NIH HHS","grant_id":"K23 MD016448","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"R01 DK118038","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"R01 DK135838","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"R21 DK123720","title":null},{"funder_name":"National Institutes of Health","grant_id":"5R01DK120861-03","title":"Financial Incentives And Nurse Coaching to Enhance Diabetes Outcomes - 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