title: Socioeconomic inequalities in risk of hospitalization for community-acquired bacteremia: a Danish population-based case-control study.
abstract: 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.
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Koch
authors.forename: Mette
authors.initials: M
authors.lastname: Søgaard
authors.forename: Mette
authors.initials: M
authors.lastname: Nørgaard
authors.forename: Reimar Wernich
authors.initials: RW
authors.lastname: Thomsen
authors.forename: Henrik Carl
authors.initials: HC
authors.lastname: Schønheyder
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology*; D016022:Case-Control Studies; D002908:Chronic Disease / Q000453:epidemiology; D017714:Community-Acquired Infections; D003718:Denmark / Q000453:epidemiology; D054242:Emigrants and Immigrants; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology
keywords: adult; bacteremia; case-control studies; chronic disease; community-acquired infection; risk factors; socioeconomic factors; substance-related disorders