Application of a novel socioeconomic measure using individual housing data in asthma research: an exploratory study

Abstract

Background:A housing-based socioeconomic index (HOUSES) was previously developed to overcome an absence of socioeconomic status (SES) measures in common databases. HOUSES is associated with child health outcomes in Olmsted County, Minnesota, USA, but generalisability to other geographic areas is unclear.Aim:To assess whether HOUSES is associated with asthma outcomes outside Olmsted County, Minnesota, USA.Methods:Using a random sample of children with asthma from Sanford Children’s Hospital, Sioux Falls, SD, USA, asthma status was determined. The primary outcome was asthma control status using Asthma Control Test and a secondary outcome was risk of persistent asthma. Home address information and property data were merged to formulate HOUSES. Other SES measures were examined: income, parental education (PE), Hollingshead and Nakao–Treas index.Results:Of a random sample of 200 children, 80 (40%) participated in the study. Of those, 13% had poorly controlled asthma. Addresses of 94% were matched with property data. HOUSES had moderate–good correlation with other SES measures except PE. Poor asthma control rates were 31.6%, 4.8% and 5.6% for patients in the lowest, intermediate and highest tertiles of HOUSES, respectively (P=0.023). HOUSES as a continuous variable was inversely associated with poorly controlled asthma (adjusted odds ratio (OR)=0.21 per 1 unit increase of HOUSES, 95% confidence interval (CI), 0.05–0.89, P=0.035). HOUSES as a continuous variable was inversely related to risk of persistent asthma (OR: 0.36 per 1 unit increase of HOUSES, 95% CI, 0.12–1.04, P=0.06).Conclusions:HOUSES appears to be generalisable and available as a measure of SES in asthma research in the absence of conventional SES measures.

Health Care Utilization by Body Mass Index in a Pediatric Population

“…28-31 Briefly, geocoded address information was used to match study subject address to geographic reference data and real property data from the Assessor's Office of the county government. A standardized HOUSES Index score was formulated by summing z-scores for 4 real property features (value, square footage, number of bedrooms and number of bathrooms) with a higher HOUSES Index score indicating a higher SES.…”

Assessing health disparities in children using a modified housing-related socioeconomic status measure: a cross-sectional study

“…Furthermore, these same health outcomes, defined by physician diagnosis or predetermined criteria, were also significantly associated with our original HOUSES index. [7][8][9][10][11][12][13] The performance of modified HOUSES for objective measure-based health outcomes can be expected to be similar to these findings. HOUSES, which is developed based on real property data for US taxation purposes, may not work well in other countries where housing data are not routinely collected or made publicly available in databases, or even in communities within the USA where housing assessments are infrequent or of poor quality.…”

“…While the HOUSES index developed in Olmsted County, MN, and was validated in Jackson County, MO, in the original study, this index was further validated to a different tax jurisdiction and real property data system in Sioux Falls, South Dakota. 12 Correlation of HOUSES with the health-related outcomes of childhood obesity, low birth weight and smoking were evaluated because the association between these outcomes and SES has been well demonstrated. [17][18][19] To assess whether fewer housing-related characteristics could be used, the relative influence (RI) of each characteristic for predicting the health outcomes (obesity, low birth weight and smoking exposure) was estimated using gradient boosting machine (GBM) models under logistic regression model frameworks.…”

“…The HOUSES index predicts health outcomes in adults and children that have previously been identified to be associated with SES (low birth weight, obesity, smoking exposure, asthma control status, pneumococcal diseases, postmyocardial infarction mortality, rheumatoid arthritis (RA) and post-RA mortality). [7][8][9][10][11][12][13] One of the challenges in calculating the original HOUSES index is the need for complex assessor's real property data generated for US taxation purposes. However, these data often does not include key variables of interest such as the number of bedrooms and bathrooms.…”

Usefulness of a home affluence scale administered to urban adolescents with asthma to estimate the family's socioeconomic status

“…Recently Harris et al [26] utilized a housing based index of SES called HOUSES derived from publicly available housing data from the local government for a group of children with asthma between the ages of 4 to 18 years that were being treated at a single institution. For the 58 subjects with available HOUSES and Asthma Control Test (ACT) data, the authors showed that it correlated with traditional measures of SES except for parental education, and also with asthma morbidity.…”