Combined social determinants of health, mortality, and adverse health outcomes in early natural menopause
Wen Yang, Yutong Zhang, Feifei Fu, Yunxia Cao, Zhaolian Wei, Dongdong TangObjective:
Early natural menopause (ENM) is associated with a higher long-term health burden, yet whether social determinants of health (SDH) modulate this risk is understudied. This study aimed to estimate the association of combined SDH with mortality and adverse health outcomes among women with ENM.
Methods:
We analyzed data from 19,912 women with ENM in the UK Biobank. Based on 14-item combined SDH scores, participants were categorized into tertiles representing favorable, medium, and unfavorable SDH groups. Multivariable Cox proportional hazards models were used to evaluate the associations of combined SDH with mortality, as well as incident cardiovascular disease (CVD), cancer, and dementia. In addition, we externally validated the mortality findings in the US National Health and Nutrition Examination Survey.
Results:
In the UK Biobank cohort, higher combined SDH scores showed a progressive association with all-cause mortality and the incidence of CVD and dementia (all
Conclusion:
Cumulative social disadvantage significantly amplifies the risks of mortality and multimorbidity in women with ENM. These findings warrant the integration of multidimensional SDH assessments into clinical management to tailor preventive strategies and mitigate disease burden in this vulnerable population.