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. 2016 Mar;70(3):286-91.
doi: 10.1136/jech-2015-205925. Epub 2015 Oct 12.

A novel housing-based socioeconomic measure predicts hospitalisation and multiple chronic conditions in a community population

Paul Y Takahashi  1 , Euijung Ryu  2 , Matthew A Hathcock  2 , Janet E Olson  2 , Suzette J Bielinski  2 , James R Cerhan  2 , Jennifer Rand-Weaver  3 , Young J Juhn  4
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A novel housing-based socioeconomic measure predicts hospitalisation and multiple chronic conditions in a community population

Paul Y Takahashi et al. J Epidemiol Community Health. 2016 Mar.

Abstract

Background: Socioeconomic status (SES) is an important predictor for outcomes of chronic diseases. However, it is often unavailable in clinical data. We sought to determine whether an individual housing-based SES index termed HOUSES can influence the likelihood of multiple chronic conditions (MCC) and hospitalisation in a community population.

Methods: Participants were residents of Olmsted County, Minnesota, aged >18 years, who were enrolled in Mayo Clinic Biobank on 31 December 2010, with follow-up until 31 December 2011. Primary outcome was all-cause hospitalisation over 1 calendar-year. Secondary outcome was MCC determined through a Minnesota Medical Tiering score. A logistic regression model was used to assess the association of HOUSES with the Minnesota tiering score. With adjustment for age, sex and MCC, the association of HOUSES with hospitalisation risk was tested using the Cox proportional hazards model.

Results: Eligible patients totalled 6402 persons (median age, 57 years; 25th-75th quartiles, 45-68 years). The lowest quartile of HOUSES was associated with a higher Minnesota tiering score after adjustment for age and sex (OR (95% CI) 2.4 (2.0 to 3.1)) when compared with the highest HOUSES quartile. Patients in the lowest HOUSES quartile had higher risk of all-cause hospitalisation (age, sex, MCC-adjusted HR (95% CI) 1.53 (1.18 to 1.98)) compared with those in the highest quartile.

Conclusions: Low SES, as assessed by HOUSES, was associated with increased risk of hospitalisation and greater MCC health burden. HOUSES may be a clinically useful surrogate for SES to assess risk stratification for patient care and clinical research.

Keywords: HEALTH BEHAVIOUR; MORBIDITY; QUALITY OF LIFE; SOCIAL FACTORS IN.

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Figures

Figure1
Figure1
Relation Between Multimorbidity as Determined by Minnesota Medical Tiering and HOUSES Index Quartiles for 6,402 Patients.
Figure 2
Figure 2
Kaplan-Meier Curves Comparing Hospitalization Risk With HOUSES Index Quartiles.
See this image and copyright information in PMC

References

    1. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA. 2012 Apr 11;307(14):1513–6. Epub 2012 Mar 14. - PubMed
    1. Naessens JM, Stroebel RJ, Finnie DM, Shah ND, Wagie AE, Litchy WJ, et al. Effect of multiple chronic conditions among working-age adults. Am J Manag Care. 2011 Feb;17(2):118–22. - PubMed
    1. Pardo-Crespo MR, Narla NP, Williams AR, Beebe TJ, Sloan J, Yawn BP, et al. Comparison of individual-level versus area-level socioeconomic measures in assessing health outcomes of children in Olmsted County, Minnesota. J Epidemiol Community Health. 2013 Apr;67(4):305–10. Epub 2013 Jan 15. - PMC - PubMed
    1. Oakes JM, Rossi PH. The measurement of SES in health research: current practice and steps toward a new approach. Soc Sci Med. 2003 Feb;56(4):769–84. - PubMed
    1. Warnecke RB, Oh A, Breen N, Gehlert S, Paskett E, Tucker KL, et al. Approaching health disparities from a population perspective: the National Institutes of Health Centers for Population Health and Health Disparities. Am J Public Health. 2008 Sep;98(9):1608–15. Epub 2008 Jul 16. - PMC - PubMed

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