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

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. To assess whether HOUSES is associated with asthma outcomes outside Olmsted County, Minnesota, USA. 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. 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). HOUSES appears to be generalisable and available as a measure of SES in asthma research in the absence of conventional SES measures. Socioeconomic status, as predicted by property data, is associated with how well children manage their asthma symptoms. Young Juhn at the Mayo Clinic in Rochester, Minnesota, USA, previously developed and validated the HOUsing-based index of SocioEconomic Status (HOUSES) in Minnesota and Missouri. The metric correlated with various health effects, including risk of obesity and exposure to cigarette smoke. To assess whether HOUSES was also predictive of health status among children with asthma, the researchers looked at a random sample of 58 children treated for the lung condition at a hospital in South Dakota. Eight of these children had poorly controlled asthma, six of whom came from the lowest socioeconomic bracket, as measured by HOUSES. The study indicates that HOUSES is a useful indicator of asthma outcomes and it confirms the tool's accuracy in another region of the United States.