Impact of socioeconomic status on depression clinical outcomes at six months in a Midwestern, United States community

Angstman, Kurt B.; Wi, Chung Il; Williams, Mark D.; Bohn, Bradley; Garrison, Gregory M.

doi:10.1016/j.jad.2021.05.098

Cited by 13 publications

(6 citation statements)

References 38 publications

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“…HOUSES Q1, the poorest quartile, was used as the reference category because it tends to be distinct from Q2, Q3, and Q4 in terms of outcomes. 49 , 50 Because the number of previous hospitalizations in 12 months and the number of previous ED visits over 6 months are highly correlated in our data (Pearson Correlation Coefficient = 0.66), we chose to include only previous hospitalizations in our multivariate analysis to eliminate issues with multicollinearity. 51 95% Confidence Intervals which did not cross unity were considered significant (Pr(>|z|) < 0.05).…”

Section: Methodsmentioning

confidence: 99%

Association of Early and Late Hospital Readmissions with a Novel Housing-Based Socioeconomic Measure

Zurek

Boswell

Miller

et al. 2022

Health Services Research and Managerial Epidemiology

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Background While socioeconomic status has been linked to hospital readmissions for several conditions, reliable measures of individual socioeconomic status are often not available. HOUSES, a new measure of individual socioeconomic status based upon objective public data about one's housing unit, is inversely associated with overall hospitalization rate but it has not been studied with respect to readmissions. Purpose To determine if patients in the lowest HOUSES quartile are more likely to be readmitted within 30 days (short-term) and 180 days (long-term). Methods A retrospective cohort study of 11 993 patients having 21 633 admissions was conducted using generalized linear mixed-effects models. Results HOUSES quartile did not show any significant association with early readmission. However, when compared to the lowest HOUSES quartile, the second quartile (OR = 0.90, 95%CI 0.83-0.98) and the third quartile (OR = 0.91, 95%CI 0.83-0.99) were associated with lower odds of late readmission while the highest quartile (OR = 0.91, 95%CI 0.82-1.01) was not statistically different. Conclusion HOUSES was associated with late readmission, but not early readmission. This may be because early readmissions are influenced by medical conditions and hospital care while late readmissions are influenced by ambulatory care and home-based factors. Since HOUSES relies on public county assessor data, it is generally available and may be used to focus interventions on those at highest risk for late readmission.

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Section: Methodsmentioning

confidence: 99%

Association of Early and Late Hospital Readmissions with a Novel Housing-Based Socioeconomic Measure

Zurek

Boswell

Miller

et al. 2022

Health Services Research and Managerial Epidemiology

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“…In the second model, our exposure was SES (using low SES [patients residing in the lowest 25% of ZIP codes by income-first quartile] as reference, compared to high SES [defined as the patients residing in the top 25% ZIP codes by income-fourth quartile])-in line with previous work. 29 In both models, we controlled for patient age, sex, and health insurance (Medicare, Medicaid, private insurance, self-pay), admission-related characteristics (whether admission was on a weekend or not, and whether admission was urgent, elective, or emergent, or other), number of chronic diseases, Elixhauser-related mortality score, and incorporated separate intercepts for each DRG, each hospital, and each time-quarter to account for differences between DRGs, between hospitals, and seasonality of aALOS. Standard errors were clustered at the hospital level.…”

Section: Study Outcomementioning

confidence: 99%

Trends in Medical and Surgical Admission Length of Stay by Race/Ethnicity and Socioeconomic Status: A Time Series Analysis

Ghosh

Unruh

Soroka

et al. 2021

Health Services Research and Managerial Epidemiology

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Background: Length of stay (LOS), a metric of hospital efficiency, differs by race/ethnicity and socioeconomic status (SES) and longer LOS is associated with adverse health outcomes. Historically, projects to improve LOS efficiency have yielded LOS reductions by 0.3 to 0.7 days per admission. Objective: To assess differences in average adjusted length of stay (aALOS) over time by race/ethnicity, and SES stratified by discharge destination (home or non-home). Method: Data were obtained from 2009-2014 Healthcare Cost and Utilization Project State Inpatient Datasets for New York, New Jersey, and Florida. Multivariate generalized linear models were used to examine trends in aALOS differences by race/ethnicity, and by high vs low SES patients (defined first vs fourth quartile of median income by zip code) controlling for patient, disease and hospital characteristics. Results: For those discharged home, racial/ethnic and SES aALOS differences remained stable from 2009 to 2014. However, among those discharged to non-home destinations, Black vs White aALOS differences increased from 0.21 days in Q1 2009, (95% confidence interval (CI): 0.13 to 0.30) to 0.32 days in Q3 2013, (95% CI: 0.23 to 0.40), and for low vs high SES patients from 0.03 days in Q1 2009 (95% CI: -0.04 to 0.1) to 0.26 days, (95% CI: 0.19 to 0.34). Notably, for patients not discharged home, racial/ethnic and SES aALOS differences increased and persisted after Q3 2011, coinciding with the introduction of the Affordable Care Act (ACA). Conclusion: Further research to understand the ACA’s policy impact on hospital efficiencies, and relationship to racial/ethnic and SES differences in LOS is warranted.

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“…An estimated 27% of non-Hispanic Black women experience depression in their lifetime [2]. Predictive factors such as gender and racial discrimination, lower socioeconomic status, cardiometabolic conditions (such as hypertension, diabetes, and obesity), and other complex life demands (such as stress from multigenerational caregiving) exist at high rates among Black women and increase the risk of psychological distress and depressive symptoms [3][4][5][6][7][8]. The COVID-19 pandemic may have further increased the prevalence estimates owing to the effects of structural gendered racism on Black women's mental health and factors caused or worsened by pandemic-related stressors, which have disproportionately affected the Black community [9].…”

Section: Introductionmentioning

confidence: 99%

Attitudes Toward Seeking Mental Health Services and Mobile Technology to Support the Management of Depression Among Black American Women: Cross-Sectional Survey Study

McCall¹,

Foster²,

Schwartz³

2023

J Med Internet Res

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Background Depression is a common mental health condition among Black American women. Many factors may contribute to the development of depressive symptoms, such as gender and racial discrimination, financial strain, chronic health conditions, and caregiving responsibilities. Barriers such as the stigmatization of mental illness, less access to treatment, the lack of or inadequate health insurance, mistrust of providers, and limited health literacy prevent marginalized populations from seeking care. Previous literature has shown that mobile health interventions are effective and can increase access to mental health services and resources. Objective We aimed to understand the attitudes and perceptions of Black women toward using mental health services and determine the acceptability and concerns of using mobile technology (ie, voice call, video call, SMS text messaging, and mobile app) to support the management of depression. Methods We launched a self-administered web-based questionnaire in October 2019 and closed it in January 2020. Women (aged ≥18 years) who identify as Black or African American or multiracial (defined as Black or African American and another race) were eligible to participate. The survey consisted of approximately 70 questions and included topics such as attitudes toward seeking professional psychological help, the acceptability of using a mobile phone to receive mental health care, and screening for depression. Results The findings (n=395) showed that younger Black women were more likely to have greater severity of depression than their older counterparts. The results also revealed that Black women have favorable views toward seeking mental health services. Respondents were the most comfortable with the use of voice calls or video calls to communicate with a professional to receive support for managing depression in comparison with SMS text messaging or mobile apps. The results revealed that higher help-seeking propensity increased the odds of indicating agreement with the use of voice calls and video calls to communicate with a professional to receive support for managing depression by 27% and 38%, respectively. However, no statistically significant odds ratios (all P>.05) were found between help-seeking propensity and respondents’ agreement to use mobile apps or SMS text messaging. Moderate to severe depression severity increased the odds of using mobile apps to communicate with a professional to receive support for managing depression by 43%; however, no statistically significant odds ratios existed for the other modalities. Privacy and confidentiality, communication issues (eg, misinterpreting text), and the impersonal feeling of communicating by mobile phone (eg, SMS text messaging) were the primary concerns. Conclusions Black American women, in general, have favorable views toward seeking mental health services and are comfortable with the use of mobile technology to receive support for managing depression. Future work should address the issues of access and consider the preferences and cultural appropriateness of the resources provided.

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Impact of socioeconomic status on depression clinical outcomes at six months in a Midwestern, United States community

Cited by 13 publications

References 38 publications

Association of Early and Late Hospital Readmissions with a Novel Housing-Based Socioeconomic Measure

Association of Early and Late Hospital Readmissions with a Novel Housing-Based Socioeconomic Measure

Trends in Medical and Surgical Admission Length of Stay by Race/Ethnicity and Socioeconomic Status: A Time Series Analysis

Attitudes Toward Seeking Mental Health Services and Mobile Technology to Support the Management of Depression Among Black American Women: Cross-Sectional Survey Study

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