ArticleArchives of public health = Archives belges de sante publique2022
Unfavorable social determinants of health are associated with higher burden of financial toxicity among patients with atherosclerotic cardiovascular disease in the US: findings from the National Health Interview Survey.
Article in Archives of public health = Archives belges de sante publique, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Financial Toxicity and Its Determinants in Cardiovascular Diseases: A Systematic Review and Bayesian Meta-Analysis.Inquiry : a journal of medical care organization, provision and financingPooled it
- Medication Nonadherence Among US Immigrants: Complex Roles of Insurance, Citizenship, and Length of Time in the United States.Healthcare (Basel, Switzerland) · 2026Article
- Patient-Proposed Solutions to Financial Toxicity After Surgery: A Longitudinal, Multicenter Qualitative Study.World journal of surgery · 2026Article
- Enhancing financial stability in healthcare through data-driven risk assessments with machine learning.Scientific reports · 2026Article
- Differences in patient-centered burdens and economic outcomes based on sociodemographic characteristics and social determinants of health: a scoping review.Frontiers in public health · 2026Article
- Bridging communities, prevention, and heart health: U.S. strategies for CHW cardiovascular training and integration.Frontiers in epidemiology · 2025Review
- Social and Legal Needs in Patients and Families With Cancer: Interaction With Patient-Level Financial Toxicity.JCO oncology practice · 2025Review
- Financial Toxicity and Kidney Disease in Children and Adults: A Scoping Review.International journal of nephrology and renovascular disease · 2025Review
- Multidimensional Poverty and Risk of Atherosclerotic Cardiovascular Disease: A U.S. National Study.JACC. Advances · 2024Article
- Financial Well-Being Among US Adults with Vascular Conditions: Differential Impacts Among Blacks and Hispanics.Ethnicity & disease · 2024Article
- THE ROLE OF HEALTH POLICY IN IMPROVING HEALTH OUTCOMES AND HEALTH EQUITY.Transactions of the American Clinical and Climatological Association · 2024Article
- A Costly Cure: Understanding and Addressing Financial Toxicity in Cardiovascular Disease Health Care Within the Domain of Social Determinants of Health.Methodist DeBakey cardiovascular journal · 2024Review
- Integrating the Polysocial Risk Score: Enhancing Comprehensive Healthcare Delivery.Methodist DeBakey cardiovascular journal · 2024Review
- The Impact of Social Determinants of Health on Eye Care Utilization in a National Sample of People with Diabetes.Ophthalmology · 2023Article
- The economic burden of individuals living with generalized myasthenia gravis and facing social determinants of health challenges.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
14 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundAtherosclerotic cardiovascular disease (ASCVD) is a major cause of financial toxicity, defined as excess financial strain from healthcare, in the US. Identifying factors that put patients at greatest risk can help inform more targeted and cost-effective interventions. Specific social determinants of health (SDOH) such as income are associated with a higher risk of experiencing financial toxicity from healthcare, however, the associations between more comprehensive measures of cumulative social disadvantage and financial toxicity from healthcare are poorly understood.
methodsUsing the National Health Interview Survey (2013-17), we assessed patients with self-reported ASCVD. We identified 34 discrete SDOH items, across 6 domains: economic stability, education, food poverty, neighborhood conditions, social context, and health systems. To capture the cumulative effect of SDOH, an aggregate score was computed as their sum, and divided into quartiles, the highest (quartile 4) containing the most unfavorable scores. Financial toxicity included presence of: difficulty paying medical bills, and/or delayed/foregone care due to cost, and/or cost-related medication non-adherence.
resultsApproximately 37% of study participants reported experiencing financial toxicity from healthcare, with a prevalence of 15% among those in SDOH Q1 vs 68% in SDOH Q4. In fully-adjusted regression analyses, individuals in the 2nd, 3rd and 4th quartiles of the aggregate SDOH score had 1.90 (95% CI 1.60, 2.26), 3.66 (95% CI 3.11, 4.35), and 8.18 (95% CI 6.83, 9.79) higher odds of reporting any financial toxicity from healthcare, when compared with participants in the 1st quartile. The associations were consistent in age-stratified analyses, and were also present in analyses restricted to non-economic SDOH domains and to 7 upstream SDOH features.
conclusionsAn unfavorable SDOH profile was strongly and independently associated with subjective financial toxicity from healthcare. This analysis provides further evidence to support policies and interventions aimed at screening for prevalent financial toxicity and for high financial toxicity risk among socially vulnerable groups.
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