{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T08:26:41Z","timestamp":1793780801841,"version":"4.6.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":174,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Behavioural Neurology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social determinants of health (SDoH) have not been comprehensively studied in relation to Parkinson\u2032s disease (PD), although they are well known to be associated with other chronic diseases. Here we assessed the relationship of a multidimensional, comprehensive measure of SDoH with the prevalence of PD in US adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 48,637 adults in the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2020, we identified PD cases based on self\u2010reported antiparkinsonian medication use. We formed a weighted multidomain SDoH score from eight indicators that assessed economic security, education, healthcare access, and social environment. Both multivariable logistic regression and restricted cubic spline (RCS) were used to estimate odds ratios and dose\u2013response relationships and were adjusted for demographic and lifestyle factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      More intensive adverse SDoH burden was significantly associated with higher PD prevalence (fully adjusted OR 1.31, 95% CI 1.16\u20131.47 per unit increase), and RCS analysis showed no evidence of nonlinearity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009for\u2009nonlinearity = 0.370). Unemployment (OR 4.15, 95% CI 2.70\u20136.40) and food insecurity (OR 1.96, 95% CI 1.39\u20132.76) were strongly associated with higher PD prevalence, whereas reported lack of health care access was associated with lower identified PD (OR 0.27, 95% CI 0.15\u20130. 49), pointing to likely ascertainment bias. When stratifying, we observed meaningful effect modification by age (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), with stronger effects in middle\u2010aged individuals (\u2264\u200960 years: OR 1.35, 95% CI 1.13\u20131.61), compared with an attenuation in older individuals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Poor SDoH were independently associated with higher PD prevalence, particularly among adults aged 60 years and younger. Unemployment and food insecurity showed strong positive associations, whereas the inverse association with healthcare access likely reflects ascertainment bias. These findings are hypothesis\u2010generating and suggest that SDoH may be relevant to PD screening and epidemiologic research. Longitudinal studies are needed to clarify temporality and causality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/bn\/3745561","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T08:05:00Z","timestamp":1782288300000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Social Determinants of Health and Their Association With Parkinson\u2032s Disease Prevalence in US Adults: Insights From NHANES 2001\u20132020"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1205-7181","authenticated-orcid":false,"given":"Jinping","family":"Fang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2681-1560","authenticated-orcid":false,"given":"Detao","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9935-433X","authenticated-orcid":false,"given":"Boyan","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30295-3"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-080952"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.30067"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-025-01010-2"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001297"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00081-6"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/00333549141291S206"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(24)00116-8"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.45309"},{"key":"e_1_2_11_10_2","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.4093\/dmj.2023.0380","article-title":"Social Determinants of Health and Cardiovascular Prevalence Among Adults With Diabetes: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study","volume":"48","author":"Zhang L.","year":"2024","journal-title":"Diabetes & Metabolism Journal"},{"key":"e_1_2_11_11_2","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.parkreldis.2020.10.017","article-title":"Effects of Socioeconomic Status on Mortality After Parkinson\u2032s Disease: A Nationwide Population-Based Matched Cohort Study in Korean Populations","volume":"80","author":"Yoon S. 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