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Division of Research, Kaiser Foundation Research Institute, Oakland, CA.
BACKGROUND. Most US medical records lack socioeconomic data, hindering studies of social gradients in health and ascertainment of whether study samples are representative of the general population. This study assessed the validity of a census-based approach in addressing these problems. METHODS. Socioeconomic data from 1980 census tracts and block groups were matched to the 1985 membership records of a large prepaid health plan (n = 1.9 million), with the link provided by each individual's residential address. Among a subset of 14,420 Black and White members, comparisons were made of the association of individual, census tract, and census block-group socioeconomic measures with hypertension, height, smoking, and reproductive history. RESULTS. Census-level and individual-level socioeconomic measures were similarly associated with the selected health outcomes. Census data permitted assessing response bias due to missing individual-level socioeconomic data and also contextual effects involving the interaction of individual- and neighborhood-level socioeconomic traits. On the basis of block-group characteristics, health plan members generally were representative of the total population; persons in impoverished neighborhoods, however, were underrepresented. CONCLUSIONS. This census-based methodology offers a valid and useful approach to overcoming the absence of socioeconomic data in most US medical records.
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 I. Janssen, W. F Boyce, K. Simpson, and W. Pickett Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents Am. J. Clinical Nutrition, January 1, 2006; 83(1): 139 - 145. [Abstract] [Full Text] [PDF]
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S. M. Frayne, J. H. Halanych, D. R. Miller, F. Wang, H. Lin, L. Pogach, E. J. Sharkansky, T. M. Keane, K. M. Skinner, C. S. Rosen, et al. Disparities in Diabetes Care: Impact of Mental Illness Arch Intern Med, December 12, 2005; 165(22): 2631 - 2638. [Abstract] [Full Text] [PDF]
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K. Simpson, I. Janssen, W. M Craig, and W. Pickett Multilevel analysis of associations between socioeconomic status and injury among Canadian adolescents J Epidemiol Community Health, December 1, 2005; 59(12): 1072 - 1077. [Abstract] [Full Text] [PDF]
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T. L. Krupski, L. Kwan, A. A. Afifi, and M. S. Litwin Geographic and Socioeconomic Variation in the Treatment of Prostate Cancer J. Clin. Oncol., November 1, 2005; 23(31): 7881 - 7888. [Abstract] [Full Text] [PDF]
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C. Iribarren, I. Tolstykh, C. P. Somkin, L. M. Ackerson, T. T. Brown, R. Scheffler, L. Syme, and I. Kawachi Sex and Racial/Ethnic Disparities in Outcomes After Acute Myocardial Infarction: A Cohort Study Among Members of a Large Integrated Health Care Delivery System in Northern California Arch Intern Med, October 10, 2005; 165(18): 2105 - 2113. [Abstract] [Full Text] [PDF]
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S. Sidney, M. Sorel, C. P. Quesenberry Jr., C. DeLuise, S. Lanes, and M. D. Eisner COPD and Incident Cardiovascular Disease Hospitalizations and Mortality: Kaiser Permanente Medical Care Program Chest, October 1, 2005; 128(4): 2068 - 2075. [Abstract] [Full Text] [PDF]
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 E. M. Andresen and D. K. Miller The Future (History) of Socioeconomic Measurement and Implications for Improving Health Outcomes Among African Americans J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2005; 60(10): 1345 - 1350. [Abstract] [Full Text] [PDF]
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M D Eisner, J Klein, S K Hammond, G Koren, G Lactao, and C Iribarren Directly measured second hand smoke exposure and asthma health outcomes Thorax, October 1, 2005; 60(10): 814 - 821. [Abstract] [Full Text] [PDF]
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L.-M. Baldwin, S. A. Dobie, K. Billingsley, Y. Cai, G. E. Wright, J. A. Dominitz, W. Barlow, J. L. Warren, and S. H. Taplin Explaining Black-White Differences in Receipt of Recommended Colon Cancer Treatment J Natl Cancer Inst, August 17, 2005; 97(16): 1211 - 1220. [Abstract] [Full Text] [PDF]
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 R. A Whitmer, E. P Gunderson, E. Barrett-Connor, C. P Quesenberry Jr, and K. Yaffe Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study BMJ, June 11, 2005; 330(7504): 1360. [Abstract] [Full Text] [PDF]
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C. A. Clarke, S. L. Glaser, T. H.M. Keegan, and A. Stroup Neighborhood Socioeconomic Status and Hodgkin's Lymphoma Incidence in California Cancer Epidemiol. Biomarkers Prev., June 1, 2005; 14(6): 1441 - 1447. [Abstract] [Full Text] [PDF]
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A. Rewers, H. Hedegaard, D. Lezotte, K. Meng, F. K. Battan, K. Emery, and R. F. Hamman Childhood Femur Fractures, Associated Injuries, and Sociodemographic Risk Factors: A Population-Based Study Pediatrics, May 1, 2005; 115(5): e543 - e552. [Abstract] [Full Text] [PDF]
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C. M. Fuller, L. N. Borrell, C. A. Latkin, S. Galea, D. C. Ompad, S. A. Strathdee, and D. Vlahov Effects of Race, Neighborhood, and Social Network on Age at Initiation of Injection Drug Use Am J Public Health, April 1, 2005; 95(4): 689 - 695. [Abstract] [Full Text] [PDF]
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S. H. Konety, M. S. Vaughan Sarrazin, and G. E. Rosenthal Patient and Hospital Differences Underlying Racial Variation in Outcomes After Coronary Artery Bypass Graft Surgery Circulation, March 15, 2005; 111(10): 1210 - 1216. [Abstract] [Full Text] [PDF]
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 J. Hsu, J. Huang, J. Kinsman, B. Fireman, R. Miller, J. Selby, and E. Ortiz Use of e-Health Services between 1999 and 2002: A Growing Digital Divide J. Am. Med. Inform. Assoc., March 1, 2005; 12(2): 164 - 171. [Abstract] [Full Text] [PDF]
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J. Lee, L. A. Croen, K. H. Backstrand, C. K. Yoshida, L. H. Henning, C. Lindan, D. M. Ferriero, H. J. Fullerton, A. J. Barkovich, and Y. W. Wu Maternal and Infant Characteristics Associated With Perinatal Arterial Stroke in the Infant JAMA, February 9, 2005; 293(6): 723 - 729. [Abstract] [Full Text] [PDF]
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R. A. Whitmer, S. Sidney, J. Selby, S. C. Johnston, and K. Yaffe Midlife cardiovascular risk factors and risk of dementia in late life Neurology, January 25, 2005; 64(2): 277 - 281. [Abstract] [Full Text] [PDF]
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