Novel Methodological Approaches to Address Social Drivers of Nutrition & Health (Poster Theater Flash Session 5)

(PTFS05-06-25) The Social Determinants of Health Index Is Associated With Diet Quality: A Cross-Sectional Study

Sunday, June 1, 2025

12:20 PM – 12:24 PM ET

Location: South Hall B (The Hub) - Poster Theater / Poster Board Number PT-6

Presenting Author(s)

SY

So-Yun Yi, PhD (she/her/hers)

Research Professional
University of Minnesota
Arlington Heights, Illinois, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

LS

Lyn M. Steffen

University of Minnesota
DJ

David R. Jacobs, Jr., Ph.D.

University of Minnesota
Minneapolis, Minnesota, United States
LJ

Lucia Juarez

The University of Alabama at Birmingham, United States
BS

Brian T. Steffen

University of Minnesota, United States
EL

Elizabeth R. Lusczek

University of Minnesota, United States
SS

Sandra Safo

University of Minnesota, United States
Hejingzi Jia, MHS, RD

PhD student/Graduate Assistant
University of Minnesota
Minneapolis, Minnesota, United States
KY

Kaifeng Yang

University of Minnesota, United States
XZ

Xia Zhou

University of Minnesota, United States
JT

James G. Terry

Vanderbilt University School of Medicine, United States
JS

James M. Shikany, DrPh

Professor
The University of Alabama
Birmingham, Alabama, United States
LV

Linda V. Van Horn, PhD, RDN

Professor
Northwestern University
Chicago, Illinois, United States

Objectives: Most existing research focused on individual social determinants of health (SDOH) components related to diet rather than the impact of overall SDOH burden. Therefore, we proposed to study the association between a cumulative SDOH index and dietary intake, hypothesizing that adverse SDOH index is associated with poor diet quality.

Methods: We studied Black and White adults aged 38–50 years in the Coronary Artery Risk Development in Young Adults (CARDIA) study, utilizing data collected at 2005-2006. the SDOH index was created based on the 5 domains from Healthy People 2030 including 1) economic stability (family income below median, no occupation), 2) education (less than high school degree), 3) healthcare (no health insurance past 2 years, no usual source of medical care), 4) neighborhood and built environment (above median neighborhood socioeconomic status deprivation score), and 5) social and community context (experienced discrimination). Each domain has a possible score of 0.2, and the sum of all domains defines the SDOH index which ranges from 0 to 1 (higher index=more adverse SDOH). Dietary intake was collected via CARDIA diet history, and the Healthy Eating Index-2020 (HEI-2020) was used to represent diet quality. Multiple linear regression models were used to examine the associations between quintiles of SDOH index and diet adjusting for age, sex, race, field center, and energy (if applicable).

Results: Among 2,686 participants, 57% were female, 44% were Black, and the mean age and HEI-2020 of the participants were 45 years and 63.5, respectively. Participants with higher SDOH index were more likely to have lower HEI-2020 (Diff_{Q4 vs. Q1}=-2.6; p<sub>trend < 0.001) and higher intakes of energy (Diff_{Q4 vs. Q1}=202 kcal/d; p<sub>trend < 0.001), saturated fat (Diff_{Q4 vs. Q1}=0.5 g/d; p<sub>trend=0.01), and added sugar (Diff_{Q4 vs. Q1}=6.3 g/d; p<sub>trend=0.01) compared to those with lower SDOH index. Intakes of carbohydrates, fiber, proteins, total fat, and sodium were not associated with SDOH (p_trend>0.05).

Conclusions: Higher adverse SDOH burden was associated with poor diet quality. This emphasizes the need for studies to address the overall SDOH on dietary intake.

Funding Sources: CARDIA is supported by the National Heart, Lung, and Blood Institute.