Abstract
Background: Obesity's risk increases for low-income, female, young, and Black patients. By extrapolation, idiopathic intracranial hypertension (IIH)—a disease associated with body mass index—would potentially display socioeconomic and demographic disparities.Methods: IIH incidence (per 100,000) was investigated with respect to sex, age, income, residence, and race/ethnicity, by querying the largest United States (US) healthcare administrative dataset (1997–2016), the National (Nationwide) Inpatient Sample.Results: Annual national incidence (with 25th and 75th quartiles) for IIH was 1.15 (0.91, 1.44). Females had an incidence of 1.97 (1.48, 2.48), larger (p = 0.0000038) than males at 0.36 (0.26, 0.38). Regarding age, largest incidence was among those 18–44 years old at 2.47 (1.84, 2.73). Low-income patients had an incidence of 1.56 (1.47, 1.82), larger (p = 0.00024) than the 1.21 (1.01, 1.36) of the middle/high. No differences (χ2 = 4.67, p = 0.097) were appreciated between urban (1.44; 1.40, 1.61), suburban (1.30; 1.09, 1.40), or rural (1.46; 1.40, 1.48) communities. For race/ethnicity (χ2 = 57, p = 2.57 × 10−12), incidence was largest for Blacks (2.05; 1.76, 2.74), followed by Whites (1.04; 0.79, 1.41), Hispanics (0.67; 0.57, 0.94), and Asian/Pacific Islanders (0.16; 0.11, 0.19). Year-to-year, incidence rose for all strata subsets except Asian/Pacific Islanders (τ = −0.84, p = 0.00000068).Conclusion: IIH demonstrates several sociodemographic disparities. Specifically, incidences are larger for those low-income, Black, 18–44 years old, or female, while annually increasing for all subsets, except Asian/Pacific Islanders. Hence, IIH differentially afflicts the US population, yielding in healthcare inequalities.
Highlights
Characterized by an elevated intracranial pressure and normal cerebrospinal fluid composition, in the absence of enlarged ventricles or space-occupying lesions, idiopathic intracranial hypertension (IIH) is a syndrome without a recognized etiology [1]
For investigating the role of socioeconomic and demographic variables on IIH, the National Inpatient Sample (NIS) was probed for the following patient characteristics: sex, age, income, location of residence, and race/ethnicity
Female incidence was statistically larger, with an estimated difference of 1.67 (Table 1 and Figure 1A)
Summary
Characterized by an elevated intracranial pressure and normal cerebrospinal fluid composition, in the absence of enlarged ventricles or space-occupying lesions, idiopathic intracranial hypertension (IIH) is a syndrome without a recognized etiology [1]. What has been recognized is 71–94% of IIH patients are comorbid with obesity [2,3,4,5]. Obesity’s risk increases for those who are low income, female, young, or Black [6, 7]. Extrapolation would suggest the presence of disparities in IIH diagnoses, when stratifying against the background of socioeconomic and demographic strata. Obesity’s risk increases for low-income, female, young, and Black patients. Idiopathic intracranial hypertension (IIH)—a disease associated with body mass index—would potentially display socioeconomic and demographic disparities
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