Association Between Social Determinants of Health and the Risk of Acute Pancreatitis and Related Diseases: A Prospective Cohort Study in the UK Biobank

BACKGROUND: Social determinants of health (SDH) encompass socioeconomic and environmental factors that influence individual health outcomes. While SDH has been studied in relation to cardiovascular and metabolic diseases, its potential relationship with acute pancreatitis (AP) remains insufficiently explored. METHODS: We conducted a prospective cohort study using data from the UK Biobank, including over 340,000 participants without a history of AP at baseline. A composite SDH score was constructed from multiple indicators, and the association between SDH and incident AP was examined using Cox proportional hazards models. Restricted cubic spline (RCS) regression was used to assess dose-response relationships. Stratified analyses were performed by demographic and clinical subgroups. Associations between SDH and AP-related diseases were also investigated. RESULTS: Elevated SDH scores were significantly associated with increased AP risk ( P < 0.001), with a linear dose-response relationship confirmed by RCS analysis. After full adjustment, the risk of AP was found to be higher in participants with unfavorable SDH (HR: 1.52, 95% CI: 1.37-1.70) compared with those with favorable SDH. In post-AP individuals, participants in the higher SDH group had increased risks of chronic pancreatitis (CP) and type 2 diabetes mellitus (T2DM). However, no significant association was found between SDH and post-AP pancreatic cancer (PC; P = 0.632). CONCLUSIONS: Social disadvantage, as reflected by higher SDH scores, is associated with high risk of AP and AP-related diseases. These findings underscore the importance of considering social context in clinical and public health efforts to reduce the burden of pancreatic diseases.