The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68246

Gary D. Klein, PhD¹, Caroline G. West, MA, MPAff², Abdul Beraima, PhD¹, and Kathleen H. Coughey, PhD². (1) Information Systems Division, Philadelphia Health Management Corporation, 260 S. Broad St., Phila, PA 19102, (2) Research and Evaluation, Philadelphia Health Management Corporation, 260 South Broad Street, Philadelphia, PA 19102

Asthma and diabetes, two of the most rapidly rising chronic conditions in the United States, are known to disproportionately impact people with lower incomes. Less evident, however, is how prevalence of these conditions varies among the non-poor of different socio-economic statuses. This paper examines the effects of Socioeconomic Status (SES) on two chronic conditions, asthma and diabetes, utilizing 2000 Census data and 2002 health survey data from Philadelphia Health Management Corporation’s Household Health Survey of over 10,000 households. SES was measured by cluster analysis of Census indicators (Community-level SES) and cluster analysis of Survey indicators (Individual-level SES). Both at the community-level and at the individual-level, low SES is a strong predictor of asthma and diabetes. Incidence of diabetes, however, varies among non-poor communities and individuals to a greater extent than does incidence of asthma. Survey data show that in southeastern Pennsylvania, only 2.6% of upper and upper-middle class adults, 5.1% of middle, 7.4 of lower middle and 11.7% of lower class adults have diabetes. When we examine asthma, the non-poor SES groups are virtually identical. This raises questions as to whether non-poor SES communities are equally impacted by environmental factors (physical and social) that matter for asthma but are unequally impacted by environmental factors that have a bearing on diabetes. These questions are partially addressed by a comparison of prevalence rates of individuals who live in SES communities that match their individual-level SES to individuals who live within the environmental confines of non-matching higher and lower SES communities.

Learning Objectives:

• Define socioeconomic status at the community-level and at the individual-level, and articulate it's importance in determining health at both levels.
• Recognize the added value that socioeconomic status has over a simpler poor/nonpoor dichotomy as a social determinant of health, by comparing asthma and diabetes prevalence rates at four socioeconomic levels.
• Articulate physical and social environmental factors that correlate with SES and increase or decrease the likelihood of communities being inflicted with chronic conditions such as asthma and diabetes.

Keywords: Chronic Illness, Social Class Measurement

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.