The Child Opportunity Index and Disparities in Pediatric Asthma Hospitalizations Across One Ohio Metropolitan Area, 2011-2013

To determine whether the Child Opportunity Index (COI), a nationally available measure of relative educational, health/environmental, and social/economic opportunity across census tracts within metropolitan areas, is associated with population- and patient-level asthma morbidity. This population-bas...

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Veröffentlicht in:The Journal of pediatrics Jg. 190; S. 200 - 206.e1
Hauptverfasser: Beck, Andrew F., Huang, Bin, Wheeler, Kathryn, Lawson, Nikki R., Kahn, Robert S., Riley, Carley L.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Inc 01.11.2017
Schlagworte:
Adolescent
asthma
Asthma - economics
Asthma - epidemiology
Asthma - etiology
Asthma - therapy
Child
Child, Preschool
Emergency Service, Hospital - statistics & numerical data
Female
Follow-Up Studies
Health Status Disparities
Hospitalization - statistics & numerical data
Humans
Infant
Logistic Models
Male
Ohio - epidemiology
pediatrics
Retrospective Studies
Risk Factors
Social Class
social determinants of health
Urban Health - economics
Urban Health - statistics & numerical data
CCHMC
social determinants of health
HEOI
SDH
pediatrics
asthma
OCOI
SEOI
COI
EOI
ED
ISSN:0022-3476, 1097-6833, 1097-6833
Online-Zugang:Volltext
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Zusammenfassung:To determine whether the Child Opportunity Index (COI), a nationally available measure of relative educational, health/environmental, and social/economic opportunity across census tracts within metropolitan areas, is associated with population- and patient-level asthma morbidity. This population-based retrospective cohort study was conducted between 2011 and 2013 in a southwest Ohio county. Participants included all children aged 1-16 years with hospitalizations or emergency department visits for asthma or wheezing at a major pediatric hospital. Patients were identified using discharge diagnosis codes and geocoded to their home census tract. The primary population-level outcome was census tract asthma hospitalization rate. The primary patient-level outcome was rehospitalization within 12 months of the index hospitalization. Census tract opportunity was characterized using the COI and its educational, health/environmental, and social/economic domains. Across 222 in-county census tracts, there were 2539 geocoded hospitalizations. The median asthma-related hospitalization rate was 5.0 per 1000 children per year (IQR, 1.9-8.9). Median hospitalization rates in very low, low, moderate, high, and very high opportunity tracts were 9.1, 7.6, 4.6, 2.1, and 1.8 per 1000, respectively (P < .0001). The social/economic domain had the most variables significantly associated with the outcome at the population level. The adjusted patient-level analyses showed that the COI was not significantly associated with a patient's risk of rehospitalization within 12 months. The COI was associated with population-level asthma morbidity. The details provided by the COI may inform interventions aimed at increasing opportunity and reducing morbidity across regions.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0022-3476
1097-6833
1097-6833
DOI:10.1016/j.jpeds.2017.08.007