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Int. J. Environ. Res. Public Health 2014, 11(11), 11597-11615; doi:10.3390/ijerph111111597

A Novel Socioeconomic Measure Using Individual Housing Data in Cardiovascular Outcome Research

1
Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
2
Department of Internal Medicine, Division of Cardiology, Soonchunhyang University Hospital, 22, Daesagwan-gil (657 Hannam-dong), Yongsan-gu, Seoul 140-743, Korea
3
Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
4
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 699780, Israel
5
Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
6
Department of Research, Olmsted Medical Center, 210 Ninth Street SE, Rochester, MN 55904, USA
7
Division of Allergic Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
*
Author to whom correspondence should be addressed.
Received: 16 August 2014 / Revised: 25 September 2014 / Accepted: 29 October 2014 / Published: 12 November 2014
(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)
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Abstract

Background: To assess whether the individual housing-based socioeconomic status (SES) measure termed HOUSES was associated with post-myocardial infarction (MI) mortality. Methods: The study was designed as a population-based cohort study, which compared post-MI mortality among Olmsted County, Minnesota, USA, residents with different SES as measured by HOUSES using Cox proportional hazards models. Subjects’ addresses at index date of MI were geocoded to real property data to formulate HOUSES (a z-score for housing value, square footage, and numbers of bedrooms and bathrooms). Educational levels were used as a comparison for the HOUSES index. Results: 637 of the 696 eligible patients with MI (92%) were successfully geocoded to real property data. Post-MI survival rates were 60% (50–72), 78% (71–85), 72% (60–87), and 87% (81–93) at 2 years for patients in the first (the lowest SES), second, third, and fourth quartiles of HOUSES, respectively (p < 0.001). HOUSES was associated with post-MI all-cause mortality, controlling for all variables except age and comorbidity (p = 0.036) but was not significant after adjusting for age and comorbidity (p = 0.24). Conclusions: Although HOUSES is associated with post-MI mortality, the differential mortality rates by HOUSES were primarily accounted for by age and comorbid conditions. HOUSES may be useful for health disparities research concerning cardiovascular outcomes, especially in overcoming the paucity of conventional SES measures in commonly used datasets. View Full-Text
Keywords: socioeconomic status; myocardial infarction; all-cause mortality; health disparities; housing socioeconomic status; myocardial infarction; all-cause mortality; health disparities; housing
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Bang, D.W.; Manemann, S.M.; Gerber, Y.; Roger, V.L.; Lohse, C.M.; Rand-Weaver, J.; Krusemark, E.; Yawn, B.P.; Juhn, Y.J. A Novel Socioeconomic Measure Using Individual Housing Data in Cardiovascular Outcome Research. Int. J. Environ. Res. Public Health 2014, 11, 11597-11615.

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