Neighborhood-level variability in asthma-related emergency department visits in Central Texas

Abstract

The extent to which incidence rates of asthma-related emergency department (ED) visits vary from neighborhood to neighborhood and predictors of neighborhood-level asthma ED visit burden are not well understood. We aimed to describe the census tract-level spatial distribution of asthma-related ED visits in Central Texas and identify neighborhood-level characteristics that explain variability in neighborhood-level asthma ED visit rates. Conditional autoregressive models were used to examine the spatial distribution of asthma-related ED visit incidence rates across census tracts in Travis County, Texas, and assess the contribution of census tract characteristics to their distribution. There were distinct patterns in ED visit incidence rates at the census tract scale. These patterns were largely unexplained by socioeconomic or selected built environment neighborhood characteristics. However, racial and ethnic composition explained 33% of the variability of ED visit incidence rates across census tracts. The census tract predictors of ED visit incidence rates differed by racial and ethnic group. Variability in asthma ED visit incidence rates are apparent at smaller spatial scales. Most of the variability in census tract-level asthma ED visit rates in Central Texas is not explained by racial and ethnic composition or other neighborhood characteristics.