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Sarcoidosis: social predictors of severity at presentation

CORRESPONDENCE: D.L. Rabin, Division of Community Health Care Studies, Georgetown University School of Medicine, 3800 Reservoir Road, N.W, Kober-Cogan 418, Washington D.C., 20007. Fax: 1 2026877230. E-mail: rabind@georgetown.edu

Keywords: Barriers to care, income, insurance, sarcoidosis, severity, socioeconomic status

Received: June 20, 2003
Accepted June 30, 2004

Supported by contracts (NO1-HR-56065, 56067, 56069, 56070, 56071, 56072, 56073, 56074, 56075) from the National Heart, Lung, and Blood Institute, USA.

To determine relationships among social predictors and sarcoidosis severity at presentation, demographic characteristics, socioeconomic status, and barriers to care, A Case-Control Etiologic Study of Sarcoidosis (ACCESS) was set up.

Patients self-reported themselves to be Black or White and were tissue-confirmed incident cases aged l8-yrs-old (n=696) who had received uniform assessment procedures within one of 10 medical centres and were studied using standardised questionnaires and physical, radiographical, and pulmonary function tests. Severity was measured by objective disease indicators, subjective measures of dyspnoea and short form-36 subindices.

The results of the study showed that lower income, the absence of private or Medicare health insurance, and other barriers to care were associated with sarcoidosis severity at presentation, as were race, sex, and age. Blacks were more likely to have severe disease by objective measures, while women were more likely than males to report subjective measures of severity. Older individuals were more likely to have severe disease by both measures.

In conclusion, it was found that low income and other financial barriers to care are significantly associated with sarcoidosis severity at presentation even after adjusting for demographic characteristics of race, sex, and age.

This article has been cited by other articles:

				M. C. Iannuzzi, B. A. Rybicki, and A. S. Teirstein Sarcoidosis N. Engl. J. Med., November 22, 2007; 357(21): 2153 - 2165. [Full Text] [PDF]

				M. D. Rossman and M. E. Kreider State of the Art. Lesson Learned from ACCESS (A Case Controlled Etiologic Study of Sarcoidosis) Proceedings of the ATS, August 15, 2007; 4(5): 453 - 456. [Abstract] [Full Text] [PDF]