Abstracts

Rationale: Epilepsy is a spectrum disorder with impact on quality of life. Social stigma, economic challenges and comorbidities can further degrade quality of life. The disproportionate burden of epilepsy in minorities and the economically disadvantaged suggest an association between epilepsy and socioeconomic status. Relatively few population based surveillance systems for epilepsy exist. The South Carolina Epilepsy Surveillance System (SCESS) uses South Carolina's Integrated Data System to collect, analyze, and monitor the incidence and prevalence and identify characteristics that impact quality of life. This analysis describes prevalence of epilepsy in the South Carolina population according to socioeconomic status. Methods: The SCESS receives data on all patient encounters with a diagnosis of epilepsy and/or unspecified seizure. As of 1995, a unique identifier allows linkage across multiple providers and services. Cases of epilepsy are confirmed as definite and probable based on a confirmatory diagnosis of epilepsy or an algorithm incorporating procedure codes, medication usage, and repeat visits. The annual prevalence of epilepsy is described by socioeconomic factors including insurance status, poverty level by county, and rural/ urban residency. Results: Between 2006 and 2010, 89,936 individuals were diagnosed with epilepsy in South Carolina. Annual prevalence in children (18 and under) was 0.54%, in adults (19 to 64) was 0.37% and was 0.24% in seniors (65 and over). Annual prevalence in females was 0.47% and in males was 0.33%. Annual prevalence in African-Americans was 0.63%, in whites was 0.32% and in Hispanics was 0.22%. Annual prevalence in persons with Medicaid was 1.67%, with Medicare was 0.30%, and private insurance was 0.15% while the annual prevalence in the uninsured was 0.22%. The prevalence in counties with high poverty was 0.40%, moderate poverty was 0.47%, and in counties with low poverty was 0.37%. The prevalence in residents of rural counties was 0.59% compared to 0.32% in residents of urban counties. Conclusions: Epilepsy prevalence was twice as high in African-Americans compared to whites. The prevalence in persons with Medicaid was nearly 7 times that of persons covered by private insurance; those insured by Medicare had 2 times the prevalence of those with private insurance. The prevalence was not very different by poverty status of counties; however, the ranges of incomes in a given county may decrease the impact of poverty on epilepsy. Rural residents have high prevalence of epilepsy and face difficulties in accessing health care because of limited availability of public transportation in the state. Our findings suggest the discordant distribution of living with epilepsy is disproportionately tilted towards vulnerable population groups.