From the Division of Neuro-ophthalmology, Departments of Neurology and Ophthalmology (V.L.B., A.G.R., M.A.T., K.S.S., R.A.A., G.T.L.), Division of Neuro-ophthalmology, Department of Neurology (A.G.H.), and Translational Center of Excellence for Neuroepidemiology and Neurology Outcomes Research (A.G.H.), Perelman School of Medicine (J.S.), Center for Clinical Epidemiology and Biostatistics (V.T., A.G.H.), University of Pennsylvania, Philadelphia.
Neurology. 2021 Jun 8;96(23):e2854-e2860. doi: 10.1212/WNL.0000000000012037. Epub 2021 May 12.
To identify relationships between idiopathic intracranial hypertension (IIH) and socioeconomic determinants of health, such as low-income status and proximity to healthy food.
This retrospective case-control study of adult female neuro-ophthalmology patients from one institution identified 223 women with and 4,783 women without IIH. Street addresses were geocoded and merged with US census data to obtain census tract-level information on income and food access. Choropleth maps visualized IIH clusters within certain neighborhoods. Logistic regression compared the proportion of patients with IIH from racial and ethnic minority backgrounds, low-income census tracts, and food deserts and swamps to controls without IIH.
In our cohort, when adjusted for age, women with IIH were more likely to be Black (odds ratio [OR] 3.96, 95% confidence interval [CI] 2.98-5.25), Hispanic (OR 2.23, 95% CI 1.14-4.36), and live in low-income tracts (OR 2.24, 95% CI 1.71-2.95) or food swamps (OR 1.54, 95% CI 1.15-2.07). Patients with IIH were less likely to live in food deserts than controls (OR 0.61, 95% CI 0.45-0.83). The association between Black race and IIH remained significant even after adjusting for other variables.
IIH is more common among Black and Hispanic women than expected even when accounting for the demographics of a metropolitan city. Some of this relationship is driven by the association of obesity and IIH incidence with low income and proximity to unhealthy foods.
确定特发性颅内高压（IIH）与健康的社会经济决定因素之间的关系，例如低收入状况和接近健康食品。
本研究回顾性分析了一家机构的成年女性神经眼科患者，共纳入 223 名 IIH 女性患者和 4783 名非 IIH 女性患者。对患者的街道地址进行地理编码，并与美国人口普查数据合并，以获取有关收入和食物获取的普查区层面信息。分层图可视化了某些社区内的 IIH 簇。逻辑回归比较了具有少数族裔背景、低收入普查区和食物沙漠和沼泽的 IIH 患者与非 IIH 患者的比例。
在本队列中，在校正年龄后，IIH 女性更有可能是黑人（优势比 [OR] 3.96，95%置信区间 [CI] 2.98-5.25）、西班牙裔（OR 2.23，95% CI 1.14-4.36），并且居住在低收入区（OR 2.24，95% CI 1.71-2.95）或食物沼泽区（OR 1.54，95% CI 1.15-2.07）。与对照组相比，IIH 患者更不可能居住在食物沙漠中（OR 0.61，95% CI 0.45-0.83）。即使在调整了其他变量后，黑人种族与 IIH 之间的关联仍然显著。
即使考虑到大都市区的人口统计学特征，IIH 在黑人和西班牙裔女性中也比预期更为常见。这种关系的部分原因是肥胖症和 IIH 发病率与低收入和接近不健康食品之间的关联。
