Acknowledging growing interest in the social and behavioral determinants of disease development, investigators used survey data from a California health system to assess two groups of middle-aged patients: 18,000 who did not have hypertension at study entry and 36,000 who did not have diabetes. Eleven social and behavioral risk factors were evaluated, including race, financial worry, intimate partner violence, neighborhood poverty, and depressive symptoms.
During 3.5 years of follow-up, the incidence of newly diagnosed hypertension ranged from 5.8% of patients with none of the specified risk factors to 7.0% for those with ≥3 factors, and incidence of newly diagnosed diabetes ranged from 3.5% for patients with none of the risk factors to 5.0% for those with ≥3 factors. Several hazard ratios (adjusted for age, sex, race/ethnicity, and body mass index) suggested significant associations. For example, financial worry conferred a 29% higher risk for developing diabetes, and intimate partner violence conferred a 68% higher risk. Patients who were widowed had a 38% higher risk for developing hypertension than did married patients.
The findings suggest that social and behavioral factors associated with health should be identified in clinical settings to identify high-risk patients and inform population management.
Read the article here.
Source: NEJM Journal Watch & JAMA Network open