A social determinants-based county-level cardiovascular mortality index to identify high-risk counties in the USA

Our novel SDOH-based SCMI consistently outperformed SVI in predicting US counties at risk of high CVD mortality. The identified leading county-level SDOH variables need further evaluation as potentially modifiable targets for community interventions. Our findings can improve county-level cardiovascular risk stratification and support efforts to mitigate geographical variations in cardiovascular mortality in the USA.