Social Determinants of Health and Central Serous Chorioretinopathy: Insights from the All of Us Research Program

Abstract

Purpose : To investigate the prevalence, individual characteristics, and effects of the social determinants of health on Central Serous Chorioretinopathy (CSCR) using data from the National Institutes of Health All of Us (AoU) Research Program.

Methods : Participants were included if they completed the “The Basics” and the “Social Determinants of Health” surveys and had electronic health record data. Data from “The Basics” survey was used to examine individual characteristics associated with CSCR, and data from the “Social Determinants of Health” survey was used to examine factors related to the psychosocial determinants that affect the health of the population. Multivariable logistic regression models were used to examine the association of individual characteristics and psychosocial factors with the presence of CSCR, adjusting for covariates.

Results : The study included 246,281 participants, of whom 0.13% (n=317/246,281) had CSCR. Significant differences (p<0.05) were observed in various factors such as age, sex at birth, race and ethnicity, education level, income, marital status, stable housing, home ownership, and active duty service status between the CSCR and no CSCR groups. Multivariable logistic regression analysis indicated that advancing age, especially among those aged ≥70 years (Odds Ratio (OR): 7.28, 95% Confidence Interval (CI): 4.39 – 12.64) and those between 50 and 59 years (OR: 5.98, 95% CI: 3.65 – 10.26), showed increased odds of CSCR. Hispanics exhibited a higher likelihood of CSCR compared to non-Hispanic white participants (OR: 1.73; 95% CI: 1.23 – 2.41). Compared to those with advanced college degrees, those with those with less than advanced college degrees were less likely to develop CSCR. No statistically significant associations were found between CSCR risk and psychosocial factors such as social cohesion, perceived neighborhood social disorder, social support, feelings of loneliness, and global stress levels.

Conclusions : An increased likelihood of CSCR was linked to Hispanic ethnicity and higher levels of education. Conducting additional longitudinal studies that encompass a diverse range of subgroups is vital to elucidate the intricate mechanisms underlying these associations.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.