Abstract
Introduction: Ambulatory care sensitive conditions (ACSCs) have been linked to higher emergency room and hospitalization rates. Research suggests social determinants of health (SDOH) may play a role; however, there is a limited understanding of the relationship between ACSCs and SDOH. This study's objective was to examine the relationship between structural and intermediary SDOH and chronic ACSC status among United States adults (U.S.). Methods: Data were drawn from the 2017 Behavioral Risk Surveillance System for 12 states and U.S. territories that completed the SDOH module (N= 111,828). Descriptive statistics and binary logistic regression analysis identified SDOH associated with a chronic ACSC status. Results: More than 45% of participants had a chronic ACSC. Individuals with ACSCs had higher odds of reporting their neighborhood as unsafe (AOR=1.25; 95%CI=1.05-1.49) than those who reported their neighborhood as extremely safe. Similarly, participants with ACSCs were significantly more likely to report challenges paying their utilities/rent/mortgage (AOR=1.18; 95%CI=1.03-1.36) than to report not experiencing challenges. Conclusions: To address chronic ACSCs, intersectoral public policies are warranted to diminish educational inequalities and racial disparities. This population would also benefit from community-based interventions that connect them to local resources that reduce stress and improve their financial stability and neighborhood safety level.
Highlights
Ambulatory care sensitive conditions (ACSCs) have been linked to higher emergency room and hospitalization rates
This study adds to the literature by providing a more in-depth understanding of the role of income and by identifying specific income factors, which can inform the development of targeted interventions that address these factors among this population. Participants who reported their neighborhood as extremely unsafe from crime had higher odds of having ACSCs than those who reported their neighborhood as extremely safe from crime. These findings provide supporting evidence to research conducted by Huang and colleagues in 2018, which determined neighborhood socioeconomics was significantly associated with emergency department visits for ACSCs among older adults[22]
It is evident that chronic ACSCs are associated with an increase in emergency room visits and hospitalizations[2,3,4,6]
Summary
Ambulatory care sensitive conditions (ACSCs) have been linked to higher emergency room and hospitalization rates. This study's objective was to examine the relationship between structural and intermediary SDOH and chronic ACSC status among United States adults (U.S.). Individuals with ACSCs had higher odds of reporting their neighborhood as unsafe (AOR=1.25; 95%CI=1.05-1.49) than those who reported their neighborhood as extremely safe. Participants with ACSCs were significantly more likely to report challenges paying their utilities/rent/mortgage (AOR=1.18; 95%CI=1.03-1.36) than to report not experiencing challenges. Conclusions: To address chronic ACSCs, intersectoral public policies are warranted to diminish educational inequalities and racial disparities. This population would benefit from community-based interventions that connect them to local resources that reduce stress and improve their financial stability and neighborhood safety level
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