Quarrier S, Li S, Penniston KL, et al. - Whether there exists a correlation of socioeconomic status (SES) with severity of kidney stone disease and 24-hour urine parameters, was investigated in this retrospective analysis of an IRB approved prospectively maintained database for nephrolithiasis. Experts classified severely distressed communities (SDC) as those with a Distressed Communities Index, a composite measure of SES, score in the top quartile (lowest for SES). A greater chance of receiving proportionally more invasive procedures and needing staged surgery at a higher rate was observed in patients from SDC. In this study, SES was shown to be correlated with a larger stone burden at the time of urologic intervention, needed proportionally more invasive procedures and more staged procedures. A correlation of lower SES with lower urine citrate and potassium was also evident.