Background
Social determinants of health (SDoH) are non-medical factors that influence individuals’ health and well-being. These factors include socioeconomic status, employment, education, access to healthcare, housing, and the environment. While there has been a recent focus on SDoH and cardiovascular disease, there has been a deficit of literature regarding these factors impacting cardiovascular health specifically of those in Texas.

Methods
The Behavioral Risk Factor Surveillance System is the largest national telephone-based survey system in the United States. The system contains de-identified public data of randomly sampled individuals. From 2017 to 2021, cross-sectional data were collected from 46,196 participants in Texas and analyzed using multivariate logistic regression models. P-values < .05 were statistically significant. Analysis was performed to determine the relationship between multiple variables and self-reported diagnoses of coronary artery disease or myocardial infarctions. These variables include demographic information and factors related to SDoH.

Results
Between 2017 – 2021 in Texas, cardiovascular disease was most often reported in groups that are unemployed, White (non-Hispanic) men, groups older than 65 with less than a high school education, with income levels less than $25,000. Multivariate logistic regression showed age groups older than 65 (OR 2.64, p-value <.0001), BMI > 25 (OR 1.38, p-value .0001), those who attended college or technical school but did not graduate (OR 1.34, p-value .0014) or did not graduate high school (OR 1.64, p-value .0001), compared to age groups 18-64, BMI < 25, college or technical school graduates, were associated with a higher odds of coronary artery disease or myocardial infarctions. When compared to participants currently employed, those with the highest odds of coronary artery disease or myocardial infarctions were retired (OR 2.30, p-value < .0001) or unable to work (OR 4.67, p-value < .0001). Former smokers (OR 1.98, p-value < .0001) and current smokers (every day: OR 2.33, p-value < .0001, some days: OR 1.98, p-value < .0001), compared to never smokers, both had significantly increased odds of coronary artery disease or myocardial infarctions.

Conclusion
There are limited number of studies examining SDoH and cardiovascular disease in Texas. Our findings suggest concerted efforts in addressing specific variables described in the study may curb the prevalence of coronary artery disease or myocardial infarctions in Texas.

References and Resources

1. CDC. Behavioral Risk Factor Surveillance System. Centers for Disease Control and Prevention. https://www.cdc.gov/brfss/index.html