Neighborhood Risk and Hospital Use for Pediatric Asthma, Rhode Island, 2005–2014

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Gjelsvik, Annie ; Rogers, Michelle L. ; Garro, Aris ; Sullivan, Adam ; Koinis-Mitchell, Daphne ; McQuaid, Elizabeth L. ; Smego, Raul ; Vivier, Patrick M.
• Description:
  Introduction
  
  Studies consistently show that children living in poor neighborhoods have worse asthma outcomes. The objective of our study was to assess the association between negative neighborhood factors (ie, neighborhood risk) and pediatric asthma hospital use.
  
  Methods
  
  This retrospective study used data from children aged 2 to 17 years in a statewide (Rhode Island) hospital network administrative database linked to US Census Bureau data. We defined an asthma visit as an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code of 493 in any diagnosis field. We used 8 highly correlated measures for each census-block group to construct an index of neighborhood risk. We used maps and linear regression to assess the association of neighborhood risk with average annual census-block–group rates of asthma emergency department visits and hospitalizations. We used multivariable analyses to identify child characteristics and neighborhood risk associated with an asthma revisit, accounting for the child’s sociodemographic information, season, and multiple measurements per child.
  
  Results
  
  From 2005 through 2014, we counted 359,195 visits for 146,889 children. Of these, 12,699 children (8.6%) had one or more asthma visits. Linear regression results showed 1.18 (95% confidence interval, 1.06–1.30) more average annual emergency departments visits per 100 children and 0.41 (95% confidence interval, 0.34–0.47) more average annual hospitalizations per 100 children in neighborhoods in the highest-risk index quintile than in neighborhoods in the lowest-risk index quintile.
  
  Conclusion
  
  Interventions to improve asthma outcomes among children should move beyond primary care or clinic settings and involve a careful evaluation of social context and environmental triggers.
  
  
• Subjects:
  Original Research
• Source:
  Prev Chronic Dis. 16
• DOI:
  http://dx.doi.org/10.5888/pcd16.180490
• ISSN:
  1545-1151
• Pubmed ID:
  31146802
• Pubmed Central ID:
  PMC6549429
• Document Type:
  Journal Article
• Funding:
  U54 GM115677/GM/NIGMS NIH HHS/United States
• Volume:
  16
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:f3312470830b34ba67e313f6f5ece18aa5607bd59126defdb07cf03566ac7acef11be0cfea669f82bd570bc2c864966f1b8ac8e9524dd5ebab65a24fec960e0e
• Download URL:
  https://stacks.cdc.gov/view/cdc/79565/cdc_79565_DS1.pdf
• File Type:
  [PDF - 615.75 KB ]