Social Determinants of Health, Cardio-Renal-Metabolic Disease, Multimorbidity, and prognosis in Community-Dwelling Adults: A prospective Chinese study
Authors' conclusion
Our findings underscore the importance of integrating SDOH assessment into CRMM risk stratification and management, with targeted resource allocation toward socially disadvantaged groups.
Study context
- Population
- Community-dwelling Chinese adults without first cardio-renal-metabolic disease at enrollment, China PEACE Million Persons Project; Cardio-renal-metabolic multimorbidity (CRMM) = ≥2 of CVD, T2D and CKD
- Participants
- 93,058 adults
- Exposure
- Unfavorable vs favorable social determinants of health (SDOH)
- Outcome
- Transitions from health to first cardio-renal-metabolic disease (FCRMD), progression to CRMM, and all-cause death
- Follow-up
- Median 5.04 years
Methodological detailscommunity-based, multistate models
- Community-based
- Multistate models
Main finding
As reported in the abstract
Transitions along CRMM progression
Unfavorable vs FavorableHazard ratio (95% CI)
Health to FCRMD
1.23(1.12–1.36)
FCRMD to CRMM
1.28(1.05–1.55)
CRMM to death
2.94(1.74–4.97)
Observational data: associations, not effects.
Further findings
Incidence of first cardio-renal-metabolic disease (FCRMD) and CRMM (overall cohort) · median follow-up 5.04 years
- Developed FCRMD
- 13,471 (32.03 per 1,000 person-years)
- Progressed to CRMM
- 2,885 (105.18 per 1,000 person-years)
SDOH components
- Educational attainment and social support showed the most consistent associations throughout CRMM progression
Original publication
Social Determinants of Health, Cardio-Renal-Metabolic Disease, Multimorbidity, and prognosis in Community-Dwelling Adults: A prospective Chinese study. Diabetes Res Clin Pract. Published 5 May 2026. doi:10.
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