Reader Response: Socioeconomic and Geographic Disparities in Idiopathic Intracranial Hypertension
Abigail LBishop, Graduate Student, University of Wisconsin - Madison
Submitted December 12, 2021
I read this paper with interest.1 We should be interested in health inequalities out of moral concern and for the opportunities they offer to understand what causes good and bad health. Measuring the distribution of health and its covariance with other possible relevant variables is more informative than measuring its distribution alone.2 Robust examination of covariances between social categories and other factors related to idiopathic intracranial hypertension (IIH) is especially crucial given its idiopathic nature. This article takes a step in that direction, but is limited to analyses of obesity occurrence. As the authors mention, obesity is common among IIH patients, but it is neither universal nor causally defined.
An equally common factor among IIH patients is cerebral venous sinus stenosis, occurring in >90% of IIH patients and about 6-18% of the general population.3,4 Why limit covariance measures meant to identify disparities in IIH to obesity-centered analyses? The main conclusion of the article could be expanded on if it also included analyses of covariances between social categories and other clinical, psychiatric, and anatomic factors that have been identified as risk factors or comorbidities of IIH. Careful consideration of relevant variables is necessary to perform meaningful, informative studies on health disparities.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Brahma VL, Snow J, Tam V, et al. Socioeconomic and Geographic Disparities in Idiopathic Intracranial Hypertension. Neurology. 2021;96(23):e2854-e2860. doi:10.1212/WNL.0000000000012037
Hausman DM, Asada Y, Hedemann T. Health inequalities and why they matter. Health Care Anal. 2002;10(2):177-191. doi:10.1023/A:1016502119050
Chan W, Green AL, Mishra A, Maxner C, Shankar JJS. Transverse venous sinus stenosis in idiopathic intracranial hypertension: a prospective pilot study. Can J Ophthalmol. 2020;55(5):401-405. doi:10.1016/j.jcjo.2020.05.008
Durst CR, Ornan DA, Reardon MA, et al. Prevalence of dural venous sinus stenosis and hypoplasia in a generalized population. J Neurointerv Surg. 2016;8(11):1173-1177. doi:10.1136/neurintsurg-2015-012147
I read this paper with interest.1 We should be interested in health inequalities out of moral concern and for the opportunities they offer to understand what causes good and bad health. Measuring the distribution of health and its covariance with other possible relevant variables is more informative than measuring its distribution alone.2 Robust examination of covariances between social categories and other factors related to idiopathic intracranial hypertension (IIH) is especially crucial given its idiopathic nature. This article takes a step in that direction, but is limited to analyses of obesity occurrence. As the authors mention, obesity is common among IIH patients, but it is neither universal nor causally defined.
An equally common factor among IIH patients is cerebral venous sinus stenosis, occurring in >90% of IIH patients and about 6-18% of the general population.3,4 Why limit covariance measures meant to identify disparities in IIH to obesity-centered analyses? The main conclusion of the article could be expanded on if it also included analyses of covariances between social categories and other clinical, psychiatric, and anatomic factors that have been identified as risk factors or comorbidities of IIH. Careful consideration of relevant variables is necessary to perform meaningful, informative studies on health disparities.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References