BACKGROUND: Social risk factors are linked to adverse health outcomes, but their total impact on long-term quality of life is obscure. We hypothesized that a higher burden of social risk factors is associated with greater decline in quality of life over 10 years.

METHODS: We examined associations between social risk factors count and decline >5 points in (i) physical component summary, and (ii) mental component summary scores from the Short Form-12 among Black and White participants in the Reasons for Geographic and Racial Differences in Stroke study (n = 14 401).

RESULTS: For physical component summary, White participants with 1 social risk factor had relative risk (RR) for decline of 1.14 [95% confidence intervals (CI): 1.07-1.12]. Those with ≥2 social risk factors had RR of 1.26 [95% CI: 1.17-1.35], after adjusting for baseline demographics, health behaviors, medical conditions, medications, and physiological variables. Black participants with 1 social risk factor had RR of 1.03 [95% CI: 0.93-1.15]. Those with ≥2 social risk factors had RR of 1.24 [95% CI: 1.13-1.36]. For mental component summary, White participants with 1 social risk factor had RR for decline of 1.19 [95% CI: 1.04-1.37]. Those with ≥2 social risk factors had RR of 1.47 [95% CI: 1.28-1.68]. Black participants with 1 social risk factor had RR of 1.18 [95% CI: 0.96-1.45]. Those with ≥2 social risk factors had RR of 1.38 [95% CI: 1.14-1.66].

CONCLUSIONS: More social risk factors increased the risk of decline of quality of life for Black and White individuals, especially impacting mental health.