Geography as a Determinant of Health: Health Services Utilization of Pediatric Respiratory Illness in a Canadian Province.

Shehzad Kassam,Susan Crawford,Jeffrey A Bakal,Jesus Serrano-Lomelin,Maria B Ospina,Anne Hicks

doi:10.3390/ijerph18168347

Abstract

Respiratory diseases contribute to high healthcare utilization rates among children. Although social inequalities play a major role in these conditions, little is known about the impact of geography as a determinant of health, particularly with regard to the difference between rural and urban centers. A regional geographic analysis was conducted using health repository data on singleton births between 2005 and 2010 in Alberta, Canada. Data were aggregated according to regional health sub-zones in the province and standardized prevalence ratios (SPRs) were determined for eight respiratory diseases (asthma, influenza, bronchitis, bronchiolitis, croup, pneumonia, and other upper and other lower respiratory tract infections). The results indicate that there are higher rates of healthcare utilization in northern compared to southern regions and in rural and remote regions compared to urban ones, after accounting for both material and social deprivation. Geography plays a role in discrepancies of healthcare utilization for pediatric respiratory diseases, and this can be used to inform the provision of health services and resource allocation across various regions.

Highlights

Respiratory illnesses are one of the leading causes of emergency department (ED)visits and hospitalizations among children under the age of five in Canada [1]
The etiology and risk factors associated with pediatric respiratory illnesses are multifaceted, and while the biomedical model is well-established in terms of understanding these conditions, exploration of the social determinants of health (SDOHs) is more recent
The Standardized prevalence ratios (SPRs) of healthcare utilization for the pediatric respiratory illnesses (Figure 2B) indicated that the greatest proportion of total healthcare utilization events occurred in the northern subzones (2.06–3.11), with the fewest occurring in the urban centers (0.46–0.73)

Summary

Introduction

Visits and hospitalizations among children under the age of five in Canada [1] This results in a significant burden to individuals and families, as well as the healthcare system. These illnesses include infectious diseases, such as pneumonia, influenza, and bronchiolitis, as well as inflammatory diseases, such as asthma. The etiology and risk factors associated with pediatric respiratory illnesses are multifaceted, and while the biomedical model is well-established in terms of understanding these conditions, exploration of the social determinants of health (SDOHs) is more recent. SDOHs are the social, economic, and cultural factors that impact health at the individual and population levels [2]. Housing conditions are a considerable determinant for these diseases because of overcrowding, the need for major repairs, and compromised indoor air quality [6,7,8,9,10,11]

Objectives

Methods

Results

Discussion

Conclusion