Coronary disease & ACSCross-sectional study
Neighborhood Social Determinants of Health and Referral to Cardiac Rehabilitation: An Analysis of the Get With The Guidelines–Coronary Artery Disease Registry
- cross-sectional data from the Get With The Guidelines-Coronary Artery Disease registry
- generalized estimating equations
- controlling for patient- and hospital-level characteristics
Authors' conclusion
CR referral was lowest among patients living in the most deprived neighborhoods. Efforts are needed to equitably improve low CR referral rates among individuals living in the most deprived neighborhoods.
Study context
- Population
- Patients discharged alive following an ST-segment-elevation myocardial infarction from 2020 to 2022patients hospitalized for acute myocardial infarction
- Participants
- 79,694 patients
- Exposure
- association between neighborhood social determinants of health (using ZIP codes) and cardiac rehabilitation (CR) referral at discharge
Main finding
Referral to CR · at discharge
Adjusted odds ratio
0.78
95% CI 0.64–0.96
most deprived Social Deprivation Index quintile vs least deprived quintile
aOR 0.78 (95% CI 0.64–0.96)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Referral to CR by neighborhood social determinants of health domains · at discharge — high proportions of residents lacking a high school degree vs least deprived quintile · lower odds of being referred to CR | 0.46 (0.31–0.68) | |
| Referral to CR by neighborhood social determinants of health domains · at discharge — unemployed residents vs least deprived quintile · lower odds of being referred to CR | 0.73 (0.58–0.91) | |
| Referral to CR by neighborhood social determinants of health domains · at discharge — foreign-born residents vs least deprived quintile · lower odds of being referred to CR | 0.63 (0.46–0.86) | |
| Referral to CR by neighborhood social determinants of health domains · at discharge — residents with limited English proficiency vs least deprived quintile · lower odds of being referred to CR | 0.51 (0.34–0.78) | |
| Referral to CR by neighborhood social determinants of health domains · at discharge — households without a vehicle vs least deprived quintile · lower odds of being referred to CR | 0.74 (0.58–0.95) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Patient characteristics and overall CR referral
- median age
- 62 years
- women
- 28%
- non-Hispanic White
- 72%
- referred to CR at discharge
- 82.6%
Original publication
Neighborhood Social Determinants of Health and Referral to Cardiac Rehabilitation: An Analysis of the Get With The Guidelines–Coronary Artery Disease Registry. Circ Popul Health Outcomes. Published 7 July 2026. doi:10.1161/circoutcomes.125.013136
Summarised from the published abstract; every number is checked against it