4.7 Article

Understanding racial disparities in childhood asthma using individual- and neighborhood-level risk factors

期刊

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 150, 期 6, 页码 1427-+

出版社

MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2022.07.024

关键词

Asthma; racial disparities; mixed-effects analysis; mediation analysis; electronic health records; environmental exposure

向作者/读者索取更多资源

Racial disparities exist in asthma-related emergency department visits among children, and these disparities are influenced by social, economic, and environmental factors. Insurance, neighborhood socioeconomic deprivation, particulate matter, and outdoor mold mediate the impact of race on emergency department visits.
Background: Racial disparities in childhood asthma outcomes result from a complex interplay of individual- and neighborhood-level factors. Objectives: We sought to examine racial disparities in asthma-related emergency department (ED) visits between African American (AA) and European American (EA) children. Methods: This is a retrospective study of patients younger than 18 years who visited the ED at Cincinnati Children's for asthma from 2009 to 2018. The outcome was number of ED visits during a year. We assessed 11 social, economic, and environmental variables. Mediation and mixed-effects analyses were used to assess relationships between race, mediators, and number of ED visits. Results: A total of 31,114 children (46.1% AA, 53.9% EA) had 186,779 asthma-related ED visits. AA children had more visits per year than EA children (2.23 vs 2.15; P < .001). Medicaid insurance was associated with a 7% increase in rate of ED visits compared with commercial insurance (1.07; 95% CI, 1.03-1.1). Neighborhood socioeconomic deprivation was associated with an increased rate of ED visits in AA but not in EA children. Area-level particulate matter with diameter less than 2.5 mu m, pollen, and outdoor mold were associated with an increased rate of ED visits for both AA and EA children (all P < .001). Associations between race and number of ED visits were mediated by insurance, area-level deprivation, particulate matter with diameter less than 2.5 mm, and outdoor mold (all P < .001), altogether accounting for 55% of the effect of race on ED visits. Race was not associated with number of ED visits (P = .796) after accounting for mediators. Conclusions: Racial disparities in asthma-related ED visits are mediated by social, economic, and environmental factors, which may be amenable to interventions aimed at improving outcomes and eliminating inequities.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据