Exploring the Relationship Between Community-Level Economic Deprivation and HIV Infection Among Hospital Admissions in Washington, DC

Abstract

Human immunodeficiency virus (HIV) infection is a significant health concern in the United States, affecting 38 million Americans. Despite a recent decline in prevalence, social determinants of health remain an important factor driving infections, particularly among minority populations. However, the relationship between community-level economic deprivation indices and HIV infection among hospital admissions has been understudied in the literature. ObjectivesThis study investigated the association between community-level economic deprivation, measured by the Distressed Community Index (DCI), and HIV infection among hospital admissions in Washington, District of Columbia (DC). MethodsWe utilized data from the State Inpatient Database (SID) for Washington, DC, between 2016 and 2019, identifying all admissions with a history of HIV. The multivariate analysis determined the association between DCI quintiles and HIV infection among hospital admissions. Also included in the multivariate analysis were patients' age, sex, race/ethnicity, insurance type, smoking status, obesity, sexually transmitted infections (STIs), hepatitis B infections, and mental health conditions.

Socioeconomic Disparities and Emergency Department Visits for Diabetic Retinopathy in California

“…This study confirms the utility of the Distressed Communities Index in predicting important health outcomes because it has successfully predicted mortality after cardiac surgery, 12 COVID-19, 13 limb amputation rates, 14 emergency department visits for firearm injuries, 15 and HIV prevalence among hospital admissions. 16 Although other ophthalmic studies have evaluated state and national emergency department databases, 17 to our knowledge this is the first study to present detailed data on emergency department presentation primarily for DR. As seen in outpatient and survey-based studies, [2][3][4]18 we found race to be predictive of a more advanced presentation of DR, with minority groups being more likely to present to the emergency department for PDR than Whites. As a corollary to previous studies that identified patients with public insurance having lower follow-up rates for PDR after emergency department visits, 19 we found that patients with public insurance were more likely to present to the emergency department for PDR than those with private insurance.…”

“…This study confirms the utility of the Distressed Communities Index in predicting important health outcomes because it has successfully predicted mortality after cardiac surgery, 12 COVID-19, 13 limb amputation rates, 14 emergency department visits for firearm injuries, 15 and HIV prevalence among hospital admissions. 16…”