A novel cumulative social advantage metric for enhancing the cardiovascular health construct and predicting mortality risk
Authors' conclusion
An enhanced CVH score including SDoH metric strongly predicted mortality among US adults.
Study context
- Population
- US adults aged 20–79y, NHANES 1999–2018
- Participants
- 46,366 adults
- Exposure
- Social advantage metric (SAM) categories and enhanced cardiovascular health (CVH) score vs LE8 alone
- Outcome
- All-cause and CV mortality
Main finding
As reported in the abstract
All-cause and CV mortality by SAM category
Highest vs lowest SAM: 67% lower all-cause and 69% lower CV mortality risk
p-trend<0.001
Highest enhanced CVH category: all-cause mortality HR
0.22(0.14-0.34) (95% CI)
Highest enhanced CVH category: CV mortality HR
0.17(0.07-0.41) (95% CI)
Observational data: associations, not effects.
Further findings
Mean SAM, by race and ethnicity
- Overall mean SAM
- 59
- White
- 66
- Black
- 47
- Hispanic
- 36
Predictive performance (C-statistic), enhanced score vs LE8 alone
- C-statistic enhanced vs LE8 (comparable)
- 0.835 vs. 0.831, p<0.001
Associations by race/ethnicity and sex
- Varied by race and ethnicity, not sex; significant in White and Black but not Hispanic adults
- P for interaction < 0.01
Original publication
A novel cumulative social advantage metric for enhancing the cardiovascular health construct and predicting mortality risk. Eur J Prev Cardiol. Published 1 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it