Lower Neighborhood SES Linked to Increased HS Severity at Diagnosis: Analysis

Key Takeaways

• Patients in lower socioeconomic status (nSES) neighborhoods had significantly higher odds of moderate-severe hidradenitis suppurativa (HS) at diagnosis.

• Additional analysis suggested race and ethnicity may modify the effect of neighborhood SES on disease severity.

New research suggests that lower neighborhood socioeconomic status (nSES) was associated with more severe hidradenitis suppurativa (HS) at the time of diagnosis.

The recent cross-sectional analysis of 462 patients newly diagnosed with hidradenitis suppurativa (HS) found that lower neighborhood socioeconomic status (nSES) was associated with more severe disease at the time of diagnosis. The cross-sectional study, which used census tract-level socioeconomic data and accounted for demographic and insurance-related confounders, included 462 patients with newly diagnosed HS. 

The study authors observed that patients living in lower SES neighborhoods had significantly greater odds of presenting with moderate to severe HS (Hurley Stage 2 or 3) in models adjusted for age and sex (OR = 1.69; 95% CI, 1.15 to 2.50; P = 0.008). The association became non-significant after adjustment for race and ethnicity (adjusted OR = 1.37; 95% CI, 0.88 to 2.14; P = 0.16), suggesting a potential confounding role of race and ethnicity in the relationship between neighborhood SES and disease severity. Adjustment for insurance type did not diminish the effect size.

The research team emphasized the need for further exploration to better understand structural and systemic factors influencing health outcomes in HS.

"Our study found that living in lower SES neighborhoods was associated with greater odds of moderate-severe HS and sheds light on the complex relationship between nSES and race and ethnicity," the authors wrote. "Future studies should identify modifiable neighborhood factors to improve HS outcomes and examine the relationship between neighborhood SES and race and ethnicity and its impact on HS outcomes in different geographical areas."

Practical Dermatology has previously covered research on the intersection of socioeconomic geographical factors and HS diagnoses.

Source: Sanchez-Anguiano M, et al. Journal of Investigative Dermatology. 2025. doi:10.1016/j.xjidi.2025.100423