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The Association Between Patient-Reported Social Risks and the HOUSES Index: A Rural-Urban Comparison.

Jessica L Sosso1, Karen M Fischer2, Chung-Il Wi2

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Summary
This summary is machine-generated.

Social risk factors are more common in rural populations, but this is primarily due to socioeconomic status (SES) as measured by the HOUSES Index, not rurality itself. The HOUSES Index effectively identifies at-risk patients in primary care settings.

Keywords:
HOUSES Indexprimary carerural healthsocial determinants of healthsocial risk factorssocioeconomic status

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Area of Science:

  • Primary Care Research
  • Social Determinants of Health
  • Health Disparities

Background:

  • Social risk factors significantly impact patient health outcomes.
  • Assessing socioeconomic status (SES) is crucial for understanding health disparities.
  • The HOUSES Index offers a novel method for SES assessment using housing data.

Purpose of the Study:

  • To determine the prevalence of patient-reported social risk factors in a rural primary care setting.
  • To evaluate the utility of the HOUSES Index in assessing socioeconomic status (SES) in this population.
  • To examine the relationship between social risk, HOUSES Index, and rurality.

Main Methods:

  • Cross-sectional analysis of adult primary care patients in the US Midwest.
  • Utilized HOUSES Index based on patient address for SES quartile ranking.
  • Collected social risk data (housing, food, transportation, finances, violence) from health records.
  • Employed mixed-effects modeling to analyze associations.

Main Results:

  • Rural patients reported higher prevalence of all social risk factors and lower SES (HOUSES quartiles).
  • HOUSES Index quartile was a significant predictor of social risk factors (OR=2.27).
  • Rurality was not independently associated with social risk after adjusting for HOUSES Index (OR=1.02).

Conclusions:

  • The higher prevalence of social risk factors in rural populations is largely explained by socioeconomic status (SES).
  • The HOUSES Index is a valuable tool for identifying at-risk patients in primary care.
  • SES, rather than rurality per se, is a key driver of social risk in this population.