Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK Biobank

Background: Evidence of the cumulative effects of social risk factors on premature mortality is quite limited. We aimed to examine the association between cumulative social risk factors and premature mortality by constructing a polysocial risk score, and to explore the influence of cardiovascular he...

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Main Authors: Wenqi Shen, Lingli Cai, Bin Wang, Jiang Li, Ying Sun, Ningjian Wang, Yingli Lu
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:The Journal of Nutrition, Health and Aging
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Online Access:http://www.sciencedirect.com/science/article/pii/S1279770725000508
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author Wenqi Shen
Lingli Cai
Bin Wang
Jiang Li
Ying Sun
Ningjian Wang
Yingli Lu
author_facet Wenqi Shen
Lingli Cai
Bin Wang
Jiang Li
Ying Sun
Ningjian Wang
Yingli Lu
author_sort Wenqi Shen
collection DOAJ
description Background: Evidence of the cumulative effects of social risk factors on premature mortality is quite limited. We aimed to examine the association between cumulative social risk factors and premature mortality by constructing a polysocial risk score, and to explore the influence of cardiovascular health on this association. Methods: A polysocial risk score was constructed by summing 11 social determinants of health. A cardiovascular health (CVH) score was calculated following the algorithm of ''Life’s Essential 8”. Premature mortality was defined as death at an age younger than 75. Cox proportional hazards model was conducted. Results: A total of 314,039 participants in the UK Biobank were included (median age 56.0 years, 53.1% women). During a median of 12.7 years of follow-up, 13,888 premature deaths were reported. Compared with participants who had a low polysocial risk score (≤3), participants with a high polysocial risk score (≥7) were more than twice as likely to die prematurely in the follow-up period (HR 2.18, 95% CI 2.06–2.30). Compared with participants with ideal CVH and low polysocial risk score, those with poor CVH and high polysocial risk score had the highest risk of premature mortality (HR 5.25, 95% CI 4.48–6.14). A significant interaction was found between CVH status and polysocial risk score on premature mortality risk (P for interaction <0.001). Conclusions: Polysocial risk score was associated with an increased risk of premature mortality, the association was exacerbated by poor CVH. Our findings indicate that limiting social inequities and encouraging people to achieve an ideal CVH are essential to reducing the burden of premature mortality.
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spelling doaj-art-b13545c43e354536bd92fcbefcbe41082025-08-20T02:13:53ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-05-0129510052710.1016/j.jnha.2025.100527Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK BiobankWenqi Shen0Lingli Cai1Bin Wang2Jiang Li3Ying Sun4Ningjian Wang5Yingli Lu6Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaInstitute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaCorresponding authors.; Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaCorresponding authors.; Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackground: Evidence of the cumulative effects of social risk factors on premature mortality is quite limited. We aimed to examine the association between cumulative social risk factors and premature mortality by constructing a polysocial risk score, and to explore the influence of cardiovascular health on this association. Methods: A polysocial risk score was constructed by summing 11 social determinants of health. A cardiovascular health (CVH) score was calculated following the algorithm of ''Life’s Essential 8”. Premature mortality was defined as death at an age younger than 75. Cox proportional hazards model was conducted. Results: A total of 314,039 participants in the UK Biobank were included (median age 56.0 years, 53.1% women). During a median of 12.7 years of follow-up, 13,888 premature deaths were reported. Compared with participants who had a low polysocial risk score (≤3), participants with a high polysocial risk score (≥7) were more than twice as likely to die prematurely in the follow-up period (HR 2.18, 95% CI 2.06–2.30). Compared with participants with ideal CVH and low polysocial risk score, those with poor CVH and high polysocial risk score had the highest risk of premature mortality (HR 5.25, 95% CI 4.48–6.14). A significant interaction was found between CVH status and polysocial risk score on premature mortality risk (P for interaction <0.001). Conclusions: Polysocial risk score was associated with an increased risk of premature mortality, the association was exacerbated by poor CVH. Our findings indicate that limiting social inequities and encouraging people to achieve an ideal CVH are essential to reducing the burden of premature mortality.http://www.sciencedirect.com/science/article/pii/S1279770725000508Polysocial risk scorePremature mortalityCardiovascular healthSocial determinants of health
spellingShingle Wenqi Shen
Lingli Cai
Bin Wang
Jiang Li
Ying Sun
Ningjian Wang
Yingli Lu
Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK Biobank
The Journal of Nutrition, Health and Aging
Polysocial risk score
Premature mortality
Cardiovascular health
Social determinants of health
title Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK Biobank
title_full Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK Biobank
title_fullStr Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK Biobank
title_full_unstemmed Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK Biobank
title_short Association of polysocial risk score, cardiovascular health status, and the risk of premature mortality: Findings from the UK Biobank
title_sort association of polysocial risk score cardiovascular health status and the risk of premature mortality findings from the uk biobank
topic Polysocial risk score
Premature mortality
Cardiovascular health
Social determinants of health
url http://www.sciencedirect.com/science/article/pii/S1279770725000508
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