Evidence map›Paper›PMID 32673521›Full record

ArticleStroke2020

Impact of Multiple Social Determinants of Health on Incident Stroke.

Evgeniya Reshetnyak, Mariella Ntamatungiro, Laura C Pinheiro, Virginia J Howard, April P Carson, Kimberly D Martin, Monika M Safford

Open access · bronzeAbstract read
In one paragraph

Article in Stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 1 pooled it
14.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 1 synthesis or guideline pooled it, 197 citations in OpenAlex.

  1. A meta-analysis of the role of neighborhood deprivation in psychotic disorders.Social psychiatry and psychiatric epidemiology · 2025
    Pooled it
  2. Trial
  3. Article
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  7. SDoH-GPT: using large language models to extract social determinants of health.Journal of the American Medical Informatics Association : JAMIA · 2026
    Article
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60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Evgeniya ReshetnyakDepartment of Medicine, Weill Cornell Medical College, Cornell University, New York, NY (E.R., L.C.P., M.M.S.).
Mariella NtamatungiroDepartment of Internal Medicine, Columbia University College of Physicians and Surgeons, New York, NY (M.N.).
Laura C PinheiroDepartment of Medicine, Weill Cornell Medical College, Cornell University, New York, NY (E.R., L.C.P., M.M.S.).
Virginia J HowardDepartment of Epidemiology, School of Public Health, University of Alabama at Birmingham (V.J.H., A.P.C., K.D.M.).
April P CarsonDepartment of Epidemiology, School of Public Health, University of Alabama at Birmingham (V.J.H., A.P.C., K.D.M.).
Kimberly D MartinDepartment of Epidemiology, School of Public Health, University of Alabama at Birmingham (V.J.H., A.P.C., K.D.M.).
Monika M SaffordDepartment of Medicine, Weill Cornell Medical College, Cornell University, New York, NY (E.R., L.C.P., M.M.S.).
Cornell University · USAlabama Department of Public Health · USColumbia University · USUniversity of Alabama at Birmingham · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
REGARDS - MI StudyR01HL080477 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI LEVITAN, EMILY B, SAFFORD, MONIKA M · 2006 to 2020
$11.6M
REasons for Geographic And Racial Differences in Stroke-Myocardial Infarction-4 (REGARDS-MI-4)R01HL165452 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI LEVITAN, EMILY B, SAFFORD, MONIKA M · 2022 to 2025
$8.3M
NHLBI NIH HHS R01 HL080477NHLBI NIH HHS R01 HL165452NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

background and purposeSocial determinants of health (SDOH) have been previously associated with incident stroke. Although SDOH often cluster within individuals, few studies have examined associations between incident stroke and multiple SDOH within the same individual. The objective was to determine the individual and cumulative effects of SDOH on incident stroke.

methodsThis study included 27 813 participants from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study, a national, representative, prospective cohort of black and white adults aged ≥45 years. SDOH was the primary exposure. The main outcome was expert adjudicated incident stroke. Cox proportional hazards models examined associations between incident stroke and SDOH, individually and as a count of SDOH, adjusting for potential confounders.

resultsThe mean age was 64.7 years (SD 9.4) at baseline; 55.4% were women and 40.4% were blacks. Over a median follow-up of 9.5 years (IQR, 6.0-11.5), we observed 1470 incident stroke events. Of 10 candidate SDOH, 7 were associated with stroke (

conclusionsIncremental increases in the number of SDOH were independently associated with higher incident stroke risk in adults aged <75 years, with no statistically significant effects observed in individuals ≥75 years. Targeting individuals with multiple SDOH may help reduce risk of stroke among vulnerable populations.

Indexed as

Health Status DisparitiesAgedAged, 80 and overBlack PeopleCohort StudiesFemaleHumansIncidenceMaleMiddle AgedPovertyProspective StudiesRisk FactorsSelf ReportSocial Determinants of HealthSocioeconomic Factorsatrial fibrillationcigarette smokingpublic healthrisk factorssocial determinants of health

Identifiers

PMID32673521
PMCPMC9264323
OpenAlexW3043380300

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.