ASSOCIATIONS BETWEEN SOCIAL DETERMINANTS OF HEALTH AND CARDIOVASCULAR HEALTH OF ADULT CANCER SURVIVORS
Main Article Content
Keywords
Cancer, Patients, Survivors, CVD, Health, Socioeconomic, Factors
Abstract
Background: Cardiovascular health in adult cancer survivors is a critical yet understudied aspect of survivorship care.
Objectives: This cross-sectional study aimed to explore the associations between social determinants of health (SDOH) and cardiovascular outcomes in a diverse population of 180 adult cancer survivors.
Methods: Demographic and clinical data, socio-economic status, access to healthcare, psychosocial factors, and cardiovascular health outcomes were assessed. Statistical analyses, including chi-square tests, t-tests, and logistic regression models, were employed to identify associations and adjust for potential confounding variables.
Results: Higher household income was significantly associated with a lower prevalence of hypertension, emphasizing the role of socio-economic factors. Regular healthcare visits and health insurance were linked to reduced hypertension and high cholesterol, highlighting the importance of healthcare access. Depression exhibited a significant association with hypertension, underscoring the interplay between psychosocial factors and cardiovascular health.
Practical Implications: Public health interventions aimed at reducing social inequalities and improving healthcare access could contribute to broader improvements in cardiovascular health in this population.
Conclusion: The study provides insights into the intricate relationships between SDOH and cardiovascular outcomes in adult cancer survivors. The findings underscore the importance of tailoring survivorship care plans to address socio-economic disparities, enhance mental health support, and promote preventive cardiovascular care. These results contribute to a holistic understanding of survivorship care, emphasizing the need for targeted interventions to improve long-term cardiovascular health in this population.
References
2. Frobisher C, Lancashire ER, Jenkinson H, et al; British Childhood Cancer Survivor Study (BCCSS) Steering Group. Employment status and occupational level of adult survivors of childhood cancer in Great Britain: the British Childhood Cancer Survivor Study. Int J Cancer. 2017;140(12):2678-2692. doi:10.1002/ijc.30696
3. Howell CR, Bjornard KL, Ness KK, et al. Cohort profile: the St. Jude Lifetime Cohort Study (SJLIFE) for paediatric cancer survivors. Int J Epidemiol. 2021;50(1):39-49. doi:10.1093/ije/dyaa203
4. Hudson MM, Ehrhardt MJ, Bhakta N, et al. Approach for classification and severity grading of long-term and late-onset health events among childhood cancer survivors in the St. Jude Lifetime Cohort. Cancer Epidemiol Biomarkers Prev. 2017;26(5):666-674. doi:10.1158/1055-9965.EPI-16-0812
5. Johannesen CDL, Langsted A, Mortensen MB, Nordestgaard BG. Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study. BMJ. 2020;371:m4266. doi:10.1136/bmj.m4266
6. Zhou D, Xi B, Zhao M, Wang L, Veeranki SP. Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study. Sci Rep. 2018;8(1):9418. doi:10.1038/s41598-018-27377-2
7. Raghavan S, Vassy JL, Ho YL, et al. Diabetes mellitus–related all-cause and cardiovascular mortality in a national cohort of adults. J Am Heart Assoc. 2019;8(4):e011295. doi:10.1161/JAHA.118.011295
8. Xu H, Cupples LA, Stokes A, Liu CT. Association of obesity with mortality over 24 years of weight history: findings from the Framingham Heart Study. JAMA Netw Open. 2018;1(7):e184587. doi:10.1001/jamanetworkopen.2018.4587
9. Tsai TY, Tu YK, Munir KM, et al. Association of hypothyroidism and mortality in the elderly population: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2020;105(6):dgz186. doi:10.1210/clinem/dgz186
10. Ngaosuwan K, Johnston DG, Godsland IF, et al. Increased mortality risk in patients with primary and secondary adrenal insufficiency. J Clin Endocrinol Metab. 2021;106(7):e2759-e2768. doi:10.1210/clinem/dgab096
11. Dixon SB, Liu Q, Ehrhardt MJ, et al. Modifiable risk factors for late mortality among five-year survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2022;40(16 suppl):10014. doi:10.1200/JCO.2022.40.16_suppl.10014
12. Foster HME, Celis-Morales CA, Nicholl BI, et al. The effect of socioeconomic deprivation on the association between an extended measurement of unhealthy lifestyle factors and health outcomes: a prospective analysis of the UK Biobank cohort. Lancet Public Health. 2018;3(12):e576-e585. doi:10.1016/S2468-2667(18)30200-7
13. Adel Fahmideh M, Schraw JM, Chintagumpala M, Lupo PJ, Oluyomi AO, Scheurer ME. Neighborhood socioeconomic deprivation and mortality in children with central nervous system tumors. Cancer Epidemiol Biomarkers Prev. 2021;30(12):2278-2285.
14. Schraw JM, Peckham-Gregory EC, Rabin KR, Scheurer ME, Lupo PJ, Oluyomi A. Area deprivation is associated with poorer overall survival in children with acute lymphoblastic leukemia. Pediatr Blood Cancer. 2020;67(9):e28525. doi:10.1002/pbc.28525
15. Pinheiro LC, Reshetnyak E, Akinyemiju T, Phillips E, Safford MM. Social determinants of health and cancer mortality in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study. Cancer. 2022 Jan 1;128(1):122-130. doi: 10.1002/cncr.33894. Epub 2021 Sep 3. PMID: 34478162; PMCID: PMC9301452.
16. Özdemir BC, Dotto GP. Racial Differences in Cancer Susceptibility and Survival: More Than the Color of the Skin? Trends Cancer. 2017;3: 181–197.
17. Singh GK, Jemal A. Socioeconomic and Racial/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950-2014: Over Six Decades of Changing Patterns and Widening Inequalities. J Environ Public Health. 2017;2017: 2819372.
18. O’Connor JM, Sedghi T, Dhodapkar M, Kane MJ, Gross CP. Factors Associated With Cancer Disparities Among Low-, Medium-, and High-Income US Counties. JAMA Netw Open. 2018;1: e183146.
19. Singh GK, Jemal A. Socioeconomic and Racial/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950-2014: Over Six Decades of Changing Patterns and Widening Inequalities. J Environ Public Health. 2017;2017: 2819372.
20. Hashibe M, Kirchhoff AC, Kepka D, et al. Disparities in cancer survival and incidence by metropolitan versus rural residence in Utah. Cancer Med. 2018;7: 1490–1497.
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Hassan Muhammed Ul Haq
MBBS Doctor, Jinnah Sindh Medical University, Karachi - Pakistan
Eesha Arshad
MBBS Doctor, Jinnah Sindh Medical University, Karachi - Pakistan
Maham Imran
MBBS Doctor, Jinnah Sindh Medical University, Karachi - Pakistan
Aamrah Wakil
MBBS Doctor, Jinnah Sindh Medical University, Karachi - Pakistan
Aleena Ali Raza
MBBS Doctor, Jinnah Sindh Medical University, Karachi - Pakistan
Farhat. R. Malik
Professor, Community Health Sciences, Peshawar Medical College, Peshawar/ Riphah International University, Islamabad - Pakistan
Nimra Sharif
Department of Zoology Wildlife and Fisheries Faculty of Sciences, University of Agriculture, Faisalabad – Pakistan
Sabrina Ahmed
MBBS, Jinnah Postgraduate Medical Center, Karachi