Abstract
Objective: To identify relationships between idiopathic intracranial hypertension (IIH) and other socioeconomic determinants of health, such as low-income status and proximity to healthy food.
Methods: 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 U.S. 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 IIH patients from racial and ethnic minority backgrounds, low-income census tracts, and food deserts and swamps to non-IIH controls.
Results: In our cohort, when adjusted for age, women with IIH were more likely to be Black (OR 3.96; 95% 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). IIH patients 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.
Conclusion: 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.
- Received August 7, 2020.
- Accepted in final form March 8, 2021.
- © 2021 American Academy of Neurology
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- Reader Response: Socioeconomic and Geographic Disparities in Idiopathic Intracranial Hypertension
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