Chung-Il Wi1, Jennifer L St Sauver2, Debra J Jacobson3, Richard S Pendegraft3, Brian D Lahr3, Euijung Ryu4, Timothy J Beebe5, Jeff A Sloan3, Jennifer L Rand-Weaver1, Elizabeth A Krusemark1, YuBin Choi1, Young J Juhn6. 1. Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN. 2. Division of Epidemiology, Mayo Clinic, Rochester, MN. 3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 4. Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN; Center for Individualized Medicine, Mayo Clinic, Rochester, MN. 5. Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN. 6. Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN. Electronic address: Juhn.young@mayo.edu.
Abstract
OBJECTIVE: To characterize health disparities in common chronic diseases among adults by socioeconomic status (SES) and ethnicity in a mixed rural-urban community of the United States. PATIENTS AND METHODS: We conducted a cross-sectional study to assess the association of the prevalence of the 5 most burdensome chronic diseases in adults with SES and ethnicity and their interaction. The Rochester Epidemiology Project medical records linkage system was used to identify the prevalence of coronary heart disease, asthma, diabetes, hypertension, and mood disorder using International Classification of Diseases, Ninth Revision codes recorded from January 1, 2005, through December 31, 2009, among all adult residents of Olmsted County, Minnesota, on April 1, 2009. For SES measurements, an individual HOUsing-based index of SocioEconomic Status (HOUSES) derived from real property data was used. Logistic regression models were used to examine the association of the prevalence of chronic diseases with ethnicity and HOUSES score and their interaction. RESULTS: We identified 88,010 eligible adults with HOUSES scores available, of whom 48,086 (54.6%) were female and 80,699 (91.7%) were non-Hispanic white; the median (interquartile range) age was 45 years (30-58 years). Overall and in the subgroup of non-Hispanic whites, SES measured by HOUSES was inversely associated with the prevalence of all 5 chronic diseases independent of age, sex, and ethnicity (P<.001). While an association of ethnicity with disease prevalence was observed for all the chronic diseases, SES modified the effect of ethnicity for clinically less overt conditions (interaction P<.05 for each condition [diabetes, hypertension, and mood disorder]) but not for coronary heart disease, a clinically more overt condition. CONCLUSION: In a mixed rural-urban setting with a predominantly non-Hispanic white population, health disparities in chronic diseases still exist across SES. The extent to which SES modifies the effect of ethnicity on the risk of chronic diseases may depend on the nature of the disease.
OBJECTIVE: To characterize health disparities in common chronic diseases among adults by socioeconomic status (SES) and ethnicity in a mixed rural-urban community of the United States. PATIENTS AND METHODS: We conducted a cross-sectional study to assess the association of the prevalence of the 5 most burdensome chronic diseases in adults with SES and ethnicity and their interaction. The Rochester Epidemiology Project medical records linkage system was used to identify the prevalence of coronary heart disease, asthma, diabetes, hypertension, and mood disorder using International Classification of Diseases, Ninth Revision codes recorded from January 1, 2005, through December 31, 2009, among all adult residents of Olmsted County, Minnesota, on April 1, 2009. For SES measurements, an individual HOUsing-based index of SocioEconomic Status (HOUSES) derived from real property data was used. Logistic regression models were used to examine the association of the prevalence of chronic diseases with ethnicity and HOUSES score and their interaction. RESULTS: We identified 88,010 eligible adults with HOUSES scores available, of whom 48,086 (54.6%) were female and 80,699 (91.7%) were non-Hispanic white; the median (interquartile range) age was 45 years (30-58 years). Overall and in the subgroup of non-Hispanic whites, SES measured by HOUSES was inversely associated with the prevalence of all 5 chronic diseases independent of age, sex, and ethnicity (P<.001). While an association of ethnicity with disease prevalence was observed for all the chronic diseases, SES modified the effect of ethnicity for clinically less overt conditions (interaction P<.05 for each condition [diabetes, hypertension, and mood disorder]) but not for coronary heart disease, a clinically more overt condition. CONCLUSION: In a mixed rural-urban setting with a predominantly non-Hispanic white population, health disparities in chronic diseases still exist across SES. The extent to which SES modifies the effect of ethnicity on the risk of chronic diseases may depend on the nature of the disease.
Authors: Jennifer L St Sauver; Brandon R Grossardt; Cynthia L Leibson; Barbara P Yawn; L Joseph Melton; Walter A Rocca Journal: Mayo Clin Proc Date: 2012-02 Impact factor: 7.616
Authors: Jennifer L St Sauver; Brandon R Grossardt; Barbara P Yawn; L Joseph Melton; Walter A Rocca Journal: Am J Epidemiol Date: 2011-03-23 Impact factor: 4.897
Authors: M D Johnson; S H Urm; J A Jung; H D Yun; G E Munitz; C Tsigrelis; L M Baddour; Y J Juhn Journal: Epidemiol Infect Date: 2012-07-03 Impact factor: 4.434
Authors: Brian T Joyce; Tao Gao; Kalsea Koss; Yinan Zheng; Andres Cardenas; Jonathan Heiss; Allan Just; Kai Zhang; Linda van Horn; Norrina Bai Allen; Philip Greenland; Sheldon Cohen; Penny Gordon-Larsen; Colter Mitchell; Sara McLanahan; Lisa Schneper; Daniel Notterman; Sheryl L Rifas-Shiman; Emily Oken; Marie-France Hivert; Robert Wright; Andrea Baccarelli; Donald Lloyd-Jones; Lifang Hou Journal: Int J Epidemiol Date: 2022-06-13 Impact factor: 9.685
Authors: Kaitlyn I Zurek; Christopher L Boswell; Nathanial E Miller; Jennifer L Pecina; Matthew D Decker; Chung I Wi; Gregory M Garrison Journal: Health Serv Res Manag Epidemiol Date: 2022-06-22
Authors: Amelia Barwise; Young J Juhn; Chung-Il Wi; Paul Novotny; Carolina Jaramillo; Ognjen Gajic; Michael E Wilson Journal: Am J Hosp Palliat Care Date: 2018-11-20 Impact factor: 2.500
Authors: Tom D Thacher; Daniel V Dudenkov; Kristin C Mara; Julie A Maxson; Chung-Il Wi; Young J Juhn Journal: J Steroid Biochem Mol Biol Date: 2019-11-18 Impact factor: 4.292
Authors: Conor S Ryan; Young J Juhn; Harsheen Kaur; Chung-Il Wi; Euijung Ryu; Katherine S King; Daniel H Lachance Journal: Neurooncol Pract Date: 2019-12-07