Neighborhood-level socioeconomic status and hidradenitis suppurativa severity

Summary: Abstract Body: We examined the association between neighborhood socioeconomic status (nSES) and hidradenitis suppurativa (HS) disease severity. In a cross-sectional study, we included adult patients with an initial recorded diagnosis of HS (defined by ICD-10 L73.2 and confirmed with chart review) in the health system during the study period (8/1/2019-5/31/2024), a San Francisco Bay Area residential address, and available Hurley staging. We used a census-tract level measure of nSES derived from 2013-2017 American Community Survey data on income, poverty, housing cost, rental cost, education, occupation, employment; census tracts were assigned quintiles based on Bay Area index value distribution. We developed logistic regression models accounting for clustering by census tract in which the binary outcome was HS disease severity (Hurley stage 1 [mild] vs 2-3 [moderate-severe]), the primary exposure was nSES quintiles dichotomized into lower SES (quintiles 1-2) vs higher SES (quintiles 3-5, ref), and covariates included age, sex, and race-ethnicity. Of 462 patients included (mean [SD] age 35.64 [12.91] years, 72.17% female), 58% had mild, 32.5% moderate, and 9.5% severe disease. In unadjusted models, we found greater odds of worse HS disease among patients residing in lower SES neighborhoods: OR (95%) 1.74 (1.18-2.56), P=0.005. Age, sex, race-adjusted models showed nSES effect attenuation, consistent with possible confounding and/or interaction effects: OR (95%) 1.37 (0.88-2.14), P=0.2. We observed evidence of an interaction between nSES and race-ethnicity (P=0.07) . In age and sex-adjusted models stratified by race-ethnicity, the direction of the effect of nSES was similar within several racial-ethnic groups but statistical differences in smaller groups were not observed. Residing in lower SES neighborhoods may be associated with greater odds of more severe HS disease. Larger studies are needed to examine the apparent complex association between nSES and race-ethnicity. Maria Elena Sanchez-Anguiano¹, Krittin Supapannachart², Erin Amerson², Haley Naik², Stephen Shiboski², Mindy Hebert-Derouen², Jinoos Yazdany², Aileen Chang² 1. UC Davis Medical Center, Sacramento, CA, United States. 2. University of California San Francisco, San Francisco, CA, United States. Clinical Research: Epidemiology and Observational Research