Background Publications

  • A rural or mixed rural-urban setting may not be immune to health disparities. A cross-sectional study was conducted to assess the association of the prevalence of the five most burdensome chronic diseases — coronary heart disease, asthma, diabetes, hypertension and mood disorder. These associations were compared in adults using socioeconomic status (SES) and ethnicity, and their interaction. The study found that health disparities in chronic diseases still exist across SES in a mixed rural-urban setting with a predominantly non-Hispanic white population such as in Olmsted County, Minnesota. The study also revealed that the extent to which SES modifies the effect of ethnicity on the risk of chronic diseases may depend on the nature of the disease.

    Wi C, St. Sauver J, Jacobson D, Pendegraft, RS, Lahr BD, Ryu E, Beebe TJ, Sloan JA, Rand-Weaver JL, Krusemark EA, Choi Y, Juhn YJ. Ethnicity, socioeconomic status, and health disparities in a mixed rural-urban US community — Olmsted County, Minnesota. Mayo Clinic Proceedings. 2016; doi:10.1016/j.mayocp.2016.02.011.

  • Area-level socioeconomic status (SES) proxy measures could be significantly different from individual SES measures. This study identified SES agreement by comparing information from telephone self-reported SES levels and SES calculated from area-level SES measures. It found that area-level SES proxy measures significantly disagree with individual SES measures. The study showed different patterns of association with health outcomes from individual-level SES measures in a mixed urban-rural setting comprised of both rural and urbanized areas.

    Pardo-Crespo MR, Narla NP, Williams AR, Beebe RJ, Sloan J, Yawn BP, Wheeler PH, Juhn YJ. Comparison of individual-level versus area-level socioeconomic measures in assessing health outcomes of children in Olmsted County, Minnesota. Journal of Epidemiology and Community Health. 2013; doi:10.1136/jech-2012-201742.

  • Genetic effect on prognosis of cancer treatment can be modified by environment. In this study, the influence of neighborhood environment on single nucleotide polymorphisms (SNPs) in prostate cancer is examined. The study found that patients with lower SES had shorter time until biochemical failure after prostatectomy.

    Rebbeck TR, Weber AL, Walker AH, Stefflova K, Tran TV, Spangler E, Chang B, Zeigler-Johnson CM. Context-dependent effects of genome-wide association study genotypes and macroenvironment on time to biochemical (prostate specific antigen) failure after prostatectomy. Cancer Epidemiology, Biomarkers & Prevention. 2010; doi:10.1158/1055-9965.EPI-10-0173.

  • Adjustment for social determinants of health can change ranking of performance of hospitals. A retrospective cohort study was conducted of 43 free-standing children's hospitals within the Pediatric Health Information System database in the calendar year 2013. It found risk adjustment for social determinants of health changed hospitals' penalty status on a readmissions-based pay-for-performance measure.

    Sills MR, Hall M, Colvin JD, Macy ML, Cutler GJ, Bettenhausen JL, Morse RB, Auger KA, Raphael JL, Gottlieb LM, Fieldston ES, Shah SS. Association of social determinants with children's hospitals' preventable readmissions performance. JAMA Pediatrics, 2016; doi:10.1001/jamapediatrics.2015.4440.