Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohorts
Abstract Aims Social determinants of health (SDHs) exert a significant influence on various health outcomes and disparities. This study aimed to explore the associations between combined SDHs and mortality, as well as adverse health outcomes among adults with depression. Methods The research includ...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Epidemiology and Psychiatric Sciences |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2045796025100176/type/journal_article |
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| author | Xin Qi Li Liu Jin Yang Chuyu Pan Jingcan Hao Wenming Wei Shiqiang Cheng Yifan Gou Boyue Zhao Yan Wen Bolun Cheng Feng Zhang |
| author_facet | Xin Qi Li Liu Jin Yang Chuyu Pan Jingcan Hao Wenming Wei Shiqiang Cheng Yifan Gou Boyue Zhao Yan Wen Bolun Cheng Feng Zhang |
| author_sort | Xin Qi |
| collection | DOAJ |
| description | Abstract
Aims
Social determinants of health (SDHs) exert a significant influence on various health outcomes and disparities. This study aimed to explore the associations between combined SDHs and mortality, as well as adverse health outcomes among adults with depression.
Methods
The research included 48,897 participants with depression from the UK Biobank and 7,771 from the US National Health and Nutrition Examination Survey (NHANES). By calculating combined SDH scores based on 14 SDHs in the UK Biobank and 9 in the US NHANES, participants were categorized into favourable, medium and unfavourable SDH groups through tertiles. Cox regression models were used to evaluate the impact of combined SDHs on mortality (all-cause, cardiovascular disease [CVD] and cancer) in both cohorts, as well as incidences of CVD, cancer and dementia in the UK Biobank.
Results
In the fully adjusted models, compared to the favourable SDH group, the hazard ratios for all-cause mortality were 1.81 (95% CI: 1.60–2.04) in the unfavourable SDH group in the UK Biobank cohort; 1.61 (95% CI: 1.31–1.98) in the medium SDH group and 2.19 (95% CI: 1.78–2.68) in the unfavourable SDH group in the US NHANES cohort. Moreover, higher levels of unfavourable SDHs were associated with increased mortality risk from CVD and cancer. Regarding disease incidence, they were significantly linked to higher incidences of CVD and dementia but not cancer in the UK Biobank.
Conclusions
Combined unfavourable SDHs were associated with elevated risks of mortality and adverse health outcomes among adults with depression, which suggested that assessing the combined impact of SDHs could serve as a key strategy in preventing and managing depression, ultimately helping to reduce the burden of disease.
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| format | Article |
| id | doaj-art-09ec1a03e5e545bc87b3295d9dfef9c4 |
| institution | Kabale University |
| issn | 2045-7960 2045-7979 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Epidemiology and Psychiatric Sciences |
| spelling | doaj-art-09ec1a03e5e545bc87b3295d9dfef9c42025-08-22T08:41:01ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792025-01-013410.1017/S2045796025100176Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohortsXin Qi0https://orcid.org/0000-0002-6040-9567Li Liu1Jin Yang2Chuyu Pan3Jingcan Hao4Wenming Wei5https://orcid.org/0000-0003-1125-2732Shiqiang Cheng6https://orcid.org/0000-0001-8427-0312Yifan Gou7Boyue Zhao8https://orcid.org/0000-0003-0808-0706Yan Wen9Bolun Cheng10https://orcid.org/0000-0003-2915-5535Feng Zhang11Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. China Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. China Precision Medicine Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaPrecision Medicine Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. China Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. China Department of Medical Administration, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaKey Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaDepartment of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. China Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, P. R. ChinaAbstract Aims Social determinants of health (SDHs) exert a significant influence on various health outcomes and disparities. This study aimed to explore the associations between combined SDHs and mortality, as well as adverse health outcomes among adults with depression. Methods The research included 48,897 participants with depression from the UK Biobank and 7,771 from the US National Health and Nutrition Examination Survey (NHANES). By calculating combined SDH scores based on 14 SDHs in the UK Biobank and 9 in the US NHANES, participants were categorized into favourable, medium and unfavourable SDH groups through tertiles. Cox regression models were used to evaluate the impact of combined SDHs on mortality (all-cause, cardiovascular disease [CVD] and cancer) in both cohorts, as well as incidences of CVD, cancer and dementia in the UK Biobank. Results In the fully adjusted models, compared to the favourable SDH group, the hazard ratios for all-cause mortality were 1.81 (95% CI: 1.60–2.04) in the unfavourable SDH group in the UK Biobank cohort; 1.61 (95% CI: 1.31–1.98) in the medium SDH group and 2.19 (95% CI: 1.78–2.68) in the unfavourable SDH group in the US NHANES cohort. Moreover, higher levels of unfavourable SDHs were associated with increased mortality risk from CVD and cancer. Regarding disease incidence, they were significantly linked to higher incidences of CVD and dementia but not cancer in the UK Biobank. Conclusions Combined unfavourable SDHs were associated with elevated risks of mortality and adverse health outcomes among adults with depression, which suggested that assessing the combined impact of SDHs could serve as a key strategy in preventing and managing depression, ultimately helping to reduce the burden of disease. https://www.cambridge.org/core/product/identifier/S2045796025100176/type/journal_articlecancercardiovascular diseasedepressionhealth disparitiessocial determinants of health |
| spellingShingle | Xin Qi Li Liu Jin Yang Chuyu Pan Jingcan Hao Wenming Wei Shiqiang Cheng Yifan Gou Boyue Zhao Yan Wen Bolun Cheng Feng Zhang Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohorts Epidemiology and Psychiatric Sciences cancer cardiovascular disease depression health disparities social determinants of health |
| title | Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohorts |
| title_full | Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohorts |
| title_fullStr | Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohorts |
| title_full_unstemmed | Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohorts |
| title_short | Combined social determinants of health contributed to adverse health outcomes among depression: evidence from two national cohorts |
| title_sort | combined social determinants of health contributed to adverse health outcomes among depression evidence from two national cohorts |
| topic | cancer cardiovascular disease depression health disparities social determinants of health |
| url | https://www.cambridge.org/core/product/identifier/S2045796025100176/type/journal_article |
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