SES Biologic Risk Assessment
Paediatric Respiratory — SEIFA 2021 IRSD
ABS SEIFA 2021

What this tool does: Socioeconomic status (SES) independently predicts biologic treatment outcomes in paediatric asthma — not through biology alone, but via adherence barriers, housing quality, ongoing allergen exposure, and chronic stress physiology. Enter a patient postcode to retrieve the ABS SEIFA 2021 IRSD decile and generate a tailored clinical action checklist for biologic initiation.

Patient Details

Why SES matters for biologic response — the HOUSES evidence base

The HOUSES index (HOUsing-based SocioEconomic Status) was developed by Juhn et al. at Mayo Clinic and validated in paediatric asthma cohorts. It uses four publicly available property variables (assessed value, floor area, bedrooms, bathrooms) to generate an individual-level SES score. Key finding: children with identical BEC and FeNO profiles respond differently to biologics depending on their SES.

Ongoing allergen exposure
Poor housing → mould, cockroach, dust mite, smoke → continuous T2 re-stimulation despite biologic therapy
Adherence barriers
Transport, appointment costs, parental work constraints, health literacy — more prevalent in low-SES families
Chronic stress biology
Adverse childhood experiences → HPA axis dysregulation → cortisol abnormalities → amplified T2 inflammatory tone
EHR data bias
Low-SES children have more missing records → AI prediction models perform worst for the most at-risk patients

Australian context: HOUSES requires individual property data not freely available in Australia. This tool uses ABS SEIFA 2021 IRSD at postcode level — the closest available proxy. SEIFA is area-level: it describes average conditions in the postcode, not the individual. Use it as a prompt for clinical enquiry. Full SEIFA 2021 dataset: abs.gov.au/seifa.

References: Chiarella SE et al. Ther Adv Respir Dis 2026;20:1–13  ·  Harris MN et al. npj Prim Care Respir Med 2014  ·  Juhn YJ et al. JAMIA 2022.