SOCIAL DETERMINANTS OF HEALTH AND CLINICAL HYPERTENSION AND DIABETES PREVALENCE ON CHICAGO'S SOUTH SIDE

Marynia Kolak, Rhys Chua, Isaac Kamber, Elizabeth L. Tung, Stephanie Besser, Emeka Anyanwu, James Liao, Luc Anselin, Corey Tabit

Research output: Contribution to journalConference articlepeer-review

Abstract

Background: Social determinants of health (SDOH) critically impact healthcare access and outcomes. However, few studies have examined spatial relationships between SDOH and disease prevalence at neighborhood scales. In this study, we merged electronic health record (EHR) data from a major Chicago hospital system with social data at the census tract level. We hypothesized that census tracts with disadvantageous SDOH have greater prevalence of hypertension and diabetes than other nearby tracts. Methods: We calculated a clinical population prevalence for patients diagnosed with hypertension, diabetes, and heart failure for each census tract. We implemented a linear and spatial regression to model prevalence rates for each disease as a function of SDOH, including poverty, minority status, food access, walkability, foreclosure risk, crime, and others. Results: The sample consisted of 279,500 true outpatient visits/encounters and 52,486 unique patients. Clinical population prevalence rates for patients with hypertension had a strong positive association with areas with high rates of poverty, minority, and disability status (Spatial Pseudo R2=0.72). Neighboring tracts with high disease rates are the strongest predictor of cardiovascular-related chronic disease by several orders of magnitude, more than the effects of age and race combined. Diabetes had similar results, though heart failure was not as well predicted using SDOH alone. Conclusion On Chicago's South Side, segregated areas hit hardest by foreclosures, largely comprised of minority homeowners, had high rates of hypertension and diabetes. Neighboring tracts with high rates of hypertension were the strongest predictor of hypertension prevalence. Advanced spatial analysis can identify especially vulnerable areas within a broader population and could be used to target interventions to the patients most in need.

Original languageEnglish (US)
Pages (from-to)1824
Number of pages1
JournalJournal of the American College of Cardiology
Volume73
Issue number9
DOIs
StatePublished - Mar 12 2019
Externally publishedYes
EventThe American College of Cardiology 68th Annual Scientific Sessions - New Orleans, United States
Duration: Mar 16 2019Mar 18 2019

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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