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Sarcoidosis severity and socioeconomic status

¹ Dept of Family Medicine, Division of Community Health Care Studies and ² Dept of Medicine, Division of Pulmonary and Critical Care Medicine, Georgetown University School of Medicine, Washington, D.C. and the ³ Division of Pulmonary Medicine, District of Columbia General Hospital, Washington, D.C., USA

CORRESPONDENCE: D.L. Rabin, Dept of Family Medicine, Georgetown University Medical Center, 3750 Reservoir Road, N.W., Washington, D.C. 20007, USA. Fax: 1 2026877108

Keywords: functional status, insurance coverage, sarcoidosis, socioeconomic status, work and activity limitations

Received: June 22, 2000
Accepted February 14, 2001

This work was supported by a grant from the National Institute of Allergy and Infectious Diseases of the National Institutes of Health, Grant no. 1-RO3-AI38937-01.

Several chronic diseases are more severe in persons who are Black, of low socioeconomic status (SES), and underinsured. The authors ask if this is true for sarcoidosis. Associations among sarcoidosis disease severity, SES, insurance coverage, and functional limitations were analysed.

Back and White sarcoidosis patients (n=110) of a municipal and university hospital sarcoidosis registry were interviewed by telephone. Data on disease severity were abstracted from patient charts.

Most patients reported good or excellent health by demographic characteristics. Low SES and no or public insurance were associated with worse health status and more severe dyspnoea. More advanced radiographic stage was associated with lower income, and forced vital capacity impairment with less education. Physical and social activity limitations due to physical and emotional disability were related to no or public insurance and lower income, but not education.

Sarcoidosis severity is associated with socioeconomic status and insurance indicators; no or public insurance and low income are associated with functional limitations. Sarcoidosis-associated limitations are substantial, emphasizing the social significance of sarcoidosis. Lack of private insurance may inhibit the use of medical care, contributing to disease severity and impairment.