| Title: | Combined social determinants of health, mortality, and adverse health outcomes in early natural menopause. |
| Journal: | Menopause The Journal of The North American Menopause Society |
| Published: | 11 Aug 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42578471/ |
| DOI: | https://doi.org/10.1097/gme.0000000000002866 |
Publication 21200
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Abstract
OBJECTIVE: 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.</p>
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.</p>
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 P for trend <0.001). Compared with the favorable SDH group, the unfavorable SDH group was linked to higher risks of all-cause mortality (hazard ratio [HR] = 1.75; 95% CI: 1.51-2.03), CVD (HR = 1.48; 95% CI: 1.29-1.70), and dementia (HR = 1.83; 95% CI: 1.30-2.57). Consistently, these all-cause mortality associations were further validated in the US National Health and Nutrition Examination Survey cohort. Notably, among all SDH variables, unemployment exhibited the strongest associations with both all-cause mortality and incident dementia.</p>
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.</p>
6 Authors
- Wen Yang
- Yutong Zhang
- Feifei Fu
- Yunxia Cao
- Zhaolian Wei
- Dongdong Tang
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