title: Association of perceived neighborhood characteristics, socioeconomic status and rural residency with health outcomes in Egyptian patients with systemic lupus erythematosus: one center study.
abstract: OBJECTIVE
  To investigate the role of perceived neighborhood characteristics, socioeconomic status (SES) and rural residency in influencing the health status outcome of Egyptian patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Eighty patients affected with SLE were consecutively included in this a single-center cross-sectional study from July, 2011 to July, 2013. Outcome measures included the Systemic Lupus Activity Questionnaire (SLAQ) score, the Medical Outcomes Study Short Form-36 Health Survey physical functioning score and Center for Epidemiologic Studies-Depression (CES-D score of ≥ 19 points). Multivariate logistic regression analyses were conducted.
  
  
  RESULTS
  Results from multivariate logistic regression analyses, a separate adjusted model of each perceived neighborhood characteristic, indicate associations of worse perceived social cohesion with higher SLAQ scores (P < 0.01) and associations of worse perceived neighborhood aesthetics and safety with lower SF-36 physical functioning scores after adjusting for covariates (P < 0.01). Regarding the association of socioeconomic status and rural residency with health status outcomes, the results found association of poor socioeconomic status with the three health status outcome measures and association between rural residency and depression symptoms. Individuals had increased odds of depressive symptoms if they perceived worse neighborhood social cohesion (odds ratio [OR]: 2.14; CI: 1.42-2.80), if they perceived worse neighborhood safety (OR: 1.64; CI: 1.02-2.40) and if they perceived worse neighborhood aesthetic characteristics (OR: 2.79; CI: 1.84-3.38).
  
  
  CONCLUSIONS
  Study findings indicate that poor socioeconomic status, rural residency and perceived neighborhood characteristics are associated with depression; worse perceived neighborhood aesthetics and safety are associated with lower SF-36 physical functioning, and worse neighborhood social cohesion is associated with higher disease activity among patients with SLE.
authors.affiliation: Department of Rheumatology and Rehabilitation, Zagazig University, Zagazig, Egypt.
authors.forename: Amal B
authors.initials: AB
authors.lastname: Abdul-Sattar
authors.affiliation: Department of Community, Environmental and Occupational Medicine, Zagazig University, Zagazig, Egypt.
authors.forename: Sahar
authors.initials: S
authors.lastname: Abou El Magd
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012111:Residence Characteristics; D012307:Risk Factors; D012423:Rural Health; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: health outcomes; neighborhood; socioeconomic status; systemic lupus erythematosus