Socio-Spatial Vulnerability Of Uncontrolled Asthma In Children And Adolescents Living In A Brazilian Urban City

Abstract

Introduction: Asthma is a multifactorial disease and is the most common chronic disease among children and adolescents. It constitutes a serious public health problem because of its severity. Environmental factors together with urban life and poverty are the main determinants of the disease. This study aims to describe the spatial and temporal distribution, identifying areas in the city of higher concentration and vulnerability to severe asthma. Methods: Was performed an ecological study of hospital admissions for asthma in the period 2002-2012, in youth under 15 years old residing in Belo Horizonte. Data from the Authorization for Hospitalization System was geocoded to the address of residence and the census tracts classified by socioeconomic vulnerability using a Health Vulnerability Index. Temporal trend analysis and spatial distribution using Kernel maps were performed. Results: The occurrence of hospitalization for asthma is higher in children aged 0-4 years and in boys. In 10-year period we observed a down trend of hospitalizations for asthma all over the city. However, a marked cluster of asthma hospitalization coincident with slum areas in the city was observed, with approximately 44% of hospitalizations clustered in areas of high social vulnerability. The present study found a seasonal feature in the occurrence of asthma hospitalization, mostly occurring in the months of March, April and May corresponding to the end of the summer and fall. Conclusion: Despite the temporal reduction of the occurrence of uncontrolled asthma among young dwellers, a remarkable concentration in social disadvantage areas of the city suggests strong roots on social and environmental determination. Urban environmental interventional studies in vulnerable areas of the city must consider the effects of intervention on uncontrolled cases of asthma.