Abstract
BackgroundIn the United States, asthma is the most common chronic disease in children, and is associated with low sociodemographic, economic, and environmental factors. ObjectiveTo investigate geographic disparities in asthma hospitalizations and the roles that race/ethnicity, health insurance, and other environmental factors played on these disparities in Lubbock County, Texas. MethodsData were obtained from the Texas Inpatient Public Use Data File for the years 1999-2018. International classification of disease codes were used to identify primary diagnoses of asthma among all severe inpatient admissions. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). ResultsOf the 248,768 patients admitted for severe conditions, 4,224 had a primary diagnosis of asthma. In multivariable-adjusted models, the odds of asthma hospitalizations varied across geographic regions of Lubbock with the Northeast having the highest age-adjusted prevalence (7.17 per 1,000) and ORs for asthma hospitalizations (OR: 1.25, CI: 1.12-1.40). Data suggested that non-Hispanic Blacks using federal insurance in the Northeast region had the highest odds for asthma hospitalizations (OR: 4.88, CI: 3.06-7.79; p-interaction = 0.001). Across all regions, a 1 μg/m3 increase in particulate matter 2.5 was associated with a 27% higher likelihood of asthma hospitalization (OR: 1.27, 95% CI: 1.23-1.31). ConclusionIn this study, geographic disparities in asthma hospitalizations were observed within Lubbock County and were significantly influenced by a disparate distribution of socioeconomic factors related to health insurance and race/ethnicity. The potential contributory role of particulate matter needs further investigation.
Highlights
Asthma, an incurable chronic disease involving the inflammation of the bronchial tubes, is a major and ever-growing public health issue that most often results in decreased quality of life, worldwide [1]
A 1 μg/m3 increase in particulate matter 2.5 was associated with a 27% higher likelihood of asthma hospitalization (OR: 1.27, 95% confidence intervals (CIs): 1.23-1.31)
Geographic location was observed to be positively associated with asthma hospitalizations; it was observed that residents of the Northeast region had higher odds of being hospitalized with severe asthma, and this was partly due to a greater proportion of residents of this region being of low socioeconomic status than the other three regions of Lubbock County [15]
Summary
An incurable chronic disease involving the inflammation of the bronchial tubes, is a major and ever-growing public health issue that most often results in decreased quality of life, worldwide [1]. In the United States, the occurrence of asthma is higher among children (9.5%) than adults (7.7%) regardless of age, sex, and ethnicity, making it the most common chronic disease among children [2]. Asthma accounts for substantial absenteeism from school than any other chronic disease in children [3]. The prevalence of asthma is increasing nationwide. From 2001 to 2017, the prevalence of asthma increased by nearly 8% [4]. In 2013, the total estimated cost of asthma due to missed work and school days, as well as mortality, was estimated to be more than $81.9 billion [5]. In the United States, asthma is the most common chronic disease in children, and is associated with low sociodemographic, economic, and environmental factors
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