Study Shows Socioeconomic Factors Have Strong Influence on Chronic Conditions, Health Quality


Leslie Champlin
Senior Public Relations Strategist
(800) 274-2237, Ext. 5224 


WASHINGTON, DC — People living in distressed neighborhoods receive less preventive care and have worse chronic conditions, according to a study of the relationship between “cold spots” and clinical outcomes.

The study, “Living in ‘Cold Spot’ Communities Is Associated with Poor Health and Health Quality(,” looked at whether the quality of chronic care management and availability of preventive care were related to living in “cold spots,” defined as areas with high rates of poverty, lower educational achievement or a high social deprivation index. Their results identified a relationship between a person’s neighborhood and rates of obesity, uncontrolled diabetes, access to pneumonia vaccines, cancer screenings and use of aspirin to prevent heart attack.

“With the exception of aspirin …, all preventive and chronic care measures were influenced by whether a patient lived in a cold spot,” wrote researcher Winston Liaw, M.D., M.P.H., co-medical director at the Robert Graham Center, and his coauthors in the May/June issue of the Journal of the American Board of Family Medicine. “…Patients were more likely to be obese, have uncontrolled diabetes, and not receive colon and prostate cancer screening if they lived in a low education cold spot. Conversely, patients were more likely to get a pneumonia vaccine and get screened for cervical cancer if they lived in a low education cold spot.”

Physicians can incorporate socioeconomic factors, educational level and other information about their patients’ neighborhoods into electronic health records. The information can help determine whether their patients live in cold spots and identify those who need more proactive outreach or additional resources to address socioeconomic needs, wrote Liaw and his coauthors.

“This reinforces the notion that deprived neighborhoods have distinct effects on health and care delivery and underscores the importance of using geography as a lens through which to view population health,” they conclude.


About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.