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Research Letter
September 2018

Association of Low Socioeconomic Status With Hidradenitis Suppurativa in the United States

Author Affiliations
  • 1Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park, New York
JAMA Dermatol. 2018;154(9):1086-1088. doi:10.1001/jamadermatol.2018.2117

Socioeconomic status (SES) is a critical determinant of health outcome; however, no previous studies, to our knowledge, have evaluated SES among patients with hidradenitis suppurativa (HS) in the United States. Therefore we sought to determine whether HS was associated with low SES in a US population-based sample.

This cross-sectional cohort analysis used multiple health systems data that constitute the data analytics and research platform (Explorys) developed by the IBM Corporation Watson Health team. Clinical information from electronic medical records, laboratories, practice management systems, and claims systems was matched using the single set of Unified Medical Language System ontologies to create longitudinal records for unique patients. The data were standardized and curated according to common controlled vocabularies and classifications systems, including the International Classification of Diseases, SNOMED-CT (Systemized Nomenclature of Medicine–Clinical Terms), LOINC (Logical Observation Identifiers Names and Codes), and RxNorm. We compared the prevalence of low SES among patients with and without HS. The SNOMED-CT term hidradenitis was used to identify patients with HS.1 The primary outcome of interest was Medicaid insurance status, which was used as a proxy for low SES.2 The study population included adults aged 18 to 64 years with an active status in the database within the past 3 years and complete information on age, sex, race/ethnicity, and body mass index. Prevalence was compared using an adjusted odds ratio from a logistic regression model controlling for age, sex, race/ethnicity, obesity, and smoking status. This study was approved by the human subjects committee at the Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York, which waived the need for informed consent for these deidentified data.