{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:46:45Z","timestamp":1791049605125,"version":"4.1.0"},"reference-count":82,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018556","name":"Science and Technology Program of Suzhou","doi-asserted-by":"publisher","award":["SKY2023028"],"award-info":[{"award-number":["SKY2023028"]}],"id":[{"id":"10.13039\/501100018556","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to examine the associations of individual and cumulative social determinants of health (SDoH) with cardiovascular disease (CVD) prevalence and sex-specific disparities among U.S. adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Employing a cross-sectional design, we analyzed data from the nationally representative National Health and Nutrition Examination Survey (NHANES, 2005\u20132018). Five core SDoH domains were operationalized through eight validated sub-indicators. Associations between individual and cumulative SDoH and CVD prevalence were assessed using survey-weighted multivariate logistic regression, with sex-stratified analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this cross-sectional sample of 35,781 participants, adverse individual SDoH and higher cumulative adverse SDoH were associated with higher odds of prevalent CVD. In the fully adjusted model (Model 2), unemployment showed a large association with prevalent CVD (AOR\u2009=\u20092.27, 95% CI: 2.01\u20132.57). In sex-stratified analyses, point estimates for some SDoH indicators were higher in women than in men, but 95% confidence intervals overlapped for many comparisons and sex-by-SDoH interaction tests were not statistically significant (all P for interaction\u2009&gt;\u20090.05). Among individual SDoH indicators, unemployment and low income (PIR\u2009&lt;\u2009300%), as well as food insecurity, showed the strongest independent associations with prevalent CVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both individual and cumulative SDoH were independently associated with prevalent CVD. Sex-stratified analyses suggested that some point estimates were larger in women than in men, but sex-by-SDoH interaction tests were not statistically significant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0344108","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T17:24:07Z","timestamp":1774545847000},"page":"e0344108","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Individual and cumulative effects of social determinants of health on cardiovascular disease: Gender-specific insights from a cross-sectional NHANES 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