Socioeconomic Inequalities in Risk of Hospitalization for Community-Acquired Bacteremia: A Danish Population-Based Case-Control Study

• Published in: American journal of epidemiology Vol. 179; no. 9; pp. 1096 - 1106
• Main Authors: Koch, Kristoffer, Søgaard, Mette, Nørgaard, Mette, Thomsen, Reimar Wernich, Schønheyder, Henrik Carl
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 01.05.2014; Oxford Publishing Limited (England)
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Aged; Bacteremia - epidemiology; Bacterial diseases; Bacterial infections; Bacterial sepsis; Biological and medical sciences; Case-Control Studies; Chronic Disease - epidemiology; Chronic illnesses; Community-Acquired Infections; Denmark - epidemiology; Drug abuse; Emigrants and Immigrants; Epidemiology; Female; General aspects; Health risk assessment; Health Status Disparities; Healthcare Disparities - statistics & numerical data; Hospitalization; Hospitalization - statistics & numerical data; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Miscellaneous; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Assessment; Socioeconomic Factors; Substance-Related Disorders - epidemiology; Denmark; Europe; risk factors; chronic disease; community-acquired infection; substance-related disorders; socioeconomic factors; adult; bacteremia; case-control studies; Socioeconomic status; Socioeconomic study; Risk; Case control study; Epidemiology; Socioeconomics; Adult; Population; Social aspect; Public health; Human; Drug addiction; Chronic disease; Substance abuse; Hospitalization; Bacteremia; Infection; Chronic; Community acquired infection; Risk factor; Bacteriosis; Danish; Economic aspect; Inequality
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwu032

In a Danish population-based case-control study, we examined the association between socioeconomic status (SES) and risk of community-acquired bacteremia, as well as the contribution of chronic diseases and substance abuse to differences in bacteremia risk. Analyses were based on 4,117 patients aged 30–65 years who were hospitalized with first-time community-acquired bacteremia during 2000–2008 and 41,170 population controls matched by sex, age, and region of residence. Individual-level information on SES (education and income), chronic diseases, and substance abuse was retrieved from public and medical registries. Conditional logistic regression was used to compute odds ratios for bacteremia. Persons of low SES had a substantially higher risk of bacteremia than those of high SES (for short duration of education vs. long duration, odds ratio = 2.30 (95% confidence interval: 2.10, 2.52); for low income vs. high income, odds ratio = 2.77 (95% confidence interval: 2.54, 3.02)). A higher prevalence of chronic diseases and substance abuse in low-SES individuals versus high-SES individuals explained 43%–48% of the socioeconomic differences in bacteremia risk. In a country with a universal welfare system, differences in the burden of chronic diseases and substance abuse seem to have major importance in explaining inequalities in bacteremia risk.