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Complex Interaction Seen Between Social Determinants of Health, Mortality

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A scoring system can help identify individuals at high risk for mortality based on their combination of social determinants of health

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Aug. 7, 2024 (HealthDay News) — There is a complex interaction among social determinants of health with mortality risk, but a scoring system is able to identify subgroups with a high risk for mortality, according to a study published online Aug. 5 in BMJ Open.

Marie-Pier Bergeron-Boucher, Ph.D., from the Interdisciplinary Centre on Population Dynamics at Syddansk Universitet in Odense, Denmark, and colleagues quantified inequalities in life span across multiple social determinants of health and created a scoring system to accurately identify those at high risk for mortality. Life tables were compared across 54 subpopulations defined by combinations of sex, marital status, education, and race using data from the Multiple Cause of Death dataset and the American Community Survey for 2015 to 2019. Partial life expectancies (PLEs) were compared between ages 30 and 90 years for all subpopulations.

The researchers found that the subpopulations with the lowest and highest PLE had a 18.0-year difference. In most pairwise comparisons, differences in PLE were not significant. A complex interaction was seen among social determinants of health, with the observed variation in life span not fully explained by any single determinant. The proposed scoring system yielded a single score that could identify subgroups at high mortality risk. In addition, a scoring system was created by cause of death to identify subgroups that could be considered at high risk for mortality from specific causes. Subgroups with similar mortality levels are often subject to different cause-specific mortality risks.

“There is a complex interaction across social determinants of health, but tools exist to simplify and understand it, allowing for better identification of individuals at high risk of mortality,” the authors write.

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