{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:49:00Z","timestamp":1786978140338,"version":"build-2736575974"},"reference-count":75,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["T32\u2010DC009401"],"award-info":[{"award-number":["T32\u2010DC009401"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined the relationship between socioeconomic deprivation and quality of life as measured by the Voice Handicap Index (VHI) in adults with voice disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross sectional design was utilized. One\u2010thousand one\u2010hundred and twenty adults with voice disorders were included in this study (mean age\u2009=\u200953.6, SD\u2009=\u200916.5; males\u2009=\u2009429 females\u2009=\u2009788). Patients were divided into the following diagnostic groups: muscle tension dysphonia (32%), benign vocal fold lesions (29.4%), laryngospasm (12.3%), vocal fold paralysis (11.1%), neurological voice disorders (6.2%), laryngeal cancer (5.9%), and presbyphonia (3%). VHI scores, Grade Roughness Breathiness Asthenia and Strain (GRBAS) ratings, age, sex, employment status, and smoking history were extracted from initial voice evaluations. Socioeconomic deprivation was measured using the Area Deprivation Index (ADI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients living in areas with the highest socioeconomic deprivation presented with greater total (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), functional (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), physical (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and emotional VHI scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) when compared to those living in more affluent areas\u2014even when controlling for dysphonia severity, age, sex, voice\u2010related diagnosis, employment status, and smoking history. The association between VHI and ADI was strongest for total score and emotional subscore, as VHI total scores increased by 0.32 (95% CI\u2009=\u20090.26\u20131.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and VHI Emotional scores increased by 0.18 (95% CI\u2009=\u20090.16\u20130.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for every 1\u2010point increase in ADI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients living with socioeconomic deprivation experienced greater voice\u2010related handicap from voice disorders than those from more affluent backgrounds. Future work is needed to better characterize the relationship between quality of life and socioeconomic deprivation in those with voice disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70510","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T03:53:47Z","timestamp":1774324427000},"page":"3503-3513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Socioeconomic Deprivation and Vocal Handicap in Adults With Voice Disorders"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9273-046X","authenticated-orcid":false,"given":"Robert Brinton","family":"Fujiki","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Thibeault","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941312200610"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2017.01.011"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2004\/023)"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1044\/2016_JSLHR\u2010S\u201015\u20100214"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.2081"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000179174.32345.41"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.1516"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30929"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21895"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2005.12.007"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0034\u201072992009000200019"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2004.03.004"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/14015430119969"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0267190514000270"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010018\u20105090\u20105"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2004.01.007"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2008.05.006"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058\u20100360.0603.66"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2005.09.007"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000324214"},{"issue":"2","key":"e_1_2_10_22_1","first-page":"61","article-title":"The Voice Handicap Index as a Tool for Assessment of the Biopsychosocial Impact of Voice Problems","volume":"3","author":"Maertens K.","year":"2007","journal-title":"B\u2010ENT"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2025.2633"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892\u20101997(00)80017\u2010X"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.08.021"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1044\/2023_AJSLP\u201022\u201000390"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001\u20106519(06)78670\u20108"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200410000-00004"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2016.02.004"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1044\/2020_JSLHR\u201020\u201000209"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2021.02.007"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29325"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26947"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24280"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.2307\/3350401"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2021.11.003"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010019\u201002279\u20106"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540\u20106040.2008.00251.x"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkaa011"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1044\/2024_JSLHR\u201024\u201000060"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.02.016"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802313"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520\u2010013\u20100143\u20105"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2022.02.009"},{"key":"e_1_2_10_45_1","volume-title":"Classification Manual for Voice Disorders\u2010I. 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