RT Journal Article
SR Electronic
T1 Socioeconomic and Geographic Disparities in Idiopathic Intracranial Hypertension
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 10.1212/WNL.0000000000012037
DO 10.1212/WNL.0000000000012037
A1 Venkatesh L. Brahma
A1 Jonathan Snow
A1 Vicky Tam
A1 Ahmara G. Ross
A1 Madhura A. Tamhankar
A1 Kenneth S. Shindler
A1 Robert A. Avery
A1 Grant T. Liu
A1 Ali G. Hamedani
YR 2021
UL http://n.neurology.org/content/early/2021/05/12/WNL.0000000000012037.abstract
AB 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.