{"doi":"10.5853/jos.2023.00626","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","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.","journal":"Journal of Stroke","year":2023,"id":348235,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9652,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":421766,"name":"Linda C. Gallo","orcid":"0000-0002-3678-5888","position":1,"is_corresponding":false},{"id":282469,"name":"Melissa Lamar","orcid":"0000-0001-6130-5543","position":2,"is_corresponding":false},{"id":870813,"name":"Olga Garcia‐Bedoya","orcid":null,"position":3,"is_corresponding":false},{"id":303807,"name":"Krista M. Perreira","orcid":"0000-0003-2906-0261","position":4,"is_corresponding":false},{"id":546833,"name":"Amber Pirzada","orcid":"0000-0003-0526-3611","position":5,"is_corresponding":false},{"id":336206,"name":"Gregory A. Talavera","orcid":"0000-0001-5360-1107","position":6,"is_corresponding":false},{"id":24888,"name":"Sylvia Smoller","orcid":null,"position":7,"is_corresponding":false},{"id":91398,"name":"Carmen R. Isasi","orcid":"0000-0003-2700-9593","position":8,"is_corresponding":false},{"id":336207,"name":"Jianwen Cai","orcid":"0000-0002-4945-6733","position":9,"is_corresponding":false},{"id":37779,"name":"Martha L. Daviglus","orcid":"0000-0002-6791-8727","position":10,"is_corresponding":false},{"id":466167,"name":"Fernando D. Testai","orcid":"0000-0002-7355-4915","position":11,"is_corresponding":false},{"id":1090483,"name":"Gabriela Trifan","orcid":"0000-0003-3427-2605","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-19T01:12:06.040073Z","pmid":"37554075","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}