Can Climate and Social Conditions Affect Patients With Rheumatic Conditions?

Recent research confirmed that patients with rheumatic conditions living in socially deprived and hot neighborhoods faced the risk of increased health care costs and rehospitalization.

A team of 5 researchers conducted this study to understand the association between climate and social vulnerability, and morbidity and health care utilization. Specifically, “we examined associations between the neighborhood Social Vulnerability Index (SVI) and the Heat Vulnerability Index (HVI) and recurrent hospitalizations among individuals with rheumatic conditions,” they said.

Using a Massachusetts multihospital centralized clinical data repository, the study included adults who had been receiving some form of rheumatology care for 3 years until 2021. They identified addresses geocoded and linked by census tract to the SVI and the HVI, and checked for hospitalization data after adjusting for age, gender, race, insurance, and comorbidities.

The final study comprised 14,401 adults with rheumatic conditions, with a mean age of 61.9 years. More than 50% of the total study population had been hospitalized; 14% were hospitalized 1-3 times and 5% were hospitalized more than 4 times.

Concentrating on the patients hospitalized more than 4 times, the authors tried to understand the impact of the SVI and HVI index on hospitalization rates. They found that patients living in high SVI areas were 1.84 times (95% CI 1.43-2.36) more likely to be hospitalized compared to those living in low SVI areas. Similarly, individuals living in high HVI areas were 1.64 times (95% CI 1.17-2.31) more likely to be hospitalized than their counterparts living in low HVI areas.

The heat vulnerability index indicates how likely a person is to be injured or harmed during periods of hot weather, according to New York State Department of Health. The social vulnerability index accounts for the negative impacts on human health caused by social communities and neighborhoods, according to the Centers for Disease Control and Prevention. Such stresses may include natural or human-caused disasters or disease outbreaks.

—Priyam Vora

Reference:
Santacroce L, Dellaripa P, Costenbader K, Collins J and Feldman C. Association of area-level heat and social vulnerability with recurrent hospitalizations among Individuals with rheumatic conditions. Arthritis Care Res. Published Online: September 7, 2022. DOI: https://doi.org/10.1002/acr.25015