The Role of Place as a Modifier of Asthma Associations among Children in Seattle

Abstract

Asthma is the most common chronic illness of childhood and its prevalence is increasing, causing much concern for identification of risk factors. Previous work in Seattle has identified strong associations between air pollution and pediatric asthma emergency department (ED) visits. According to the CDC, Washington State’s asthma prevalence is among the highest in the nation and steadily increasing. Higher rates of asthma are found in African American children, and while many factors including socio-economic status and birth weight have been shown to be related to asthma prevalence, it has been difficult to account for the difference between various races. Here we examine whether this racial difference can be explained by neighborhood characteristics, such as racial composition, socioeconomic status, and land use. We use the Comprehensive Hospital Abstract Reporting System (CHARS) data from 2009-2016 in Seattle, WA and air pollution data from the Community Multiscale Air Quality Modeling System (CMAQ) along with neighborhood socioeconomic data (median income, percent below poverty, percent unemployed and percent white) from the American Community Survey (ACS) and land use data to explore the relationship between hospital admission rates for asthma and air pollution, race, and neighborhood characteristics. We use panel data statistical methods to explore these associations. Preliminary results demonstrate that in Seattle there are 8,315 ER visits for a primary or secondary diagnosis of asthma in children between the ages of 0-18. African Americans represent 7.0% of the population in Seattle yet of the pediatric visits, 1,225 (14.7%) were for African American children. The zipcodes with the highest counts of asthma also have higher ethnic diversity (> 20% black and < 30% white), high population density (> 5300/ mile2 compared to the average in Seattle of 4721/ mile2) and are lower income neighborhoods (median household income < $67,000 compared to $75,000 in Seattle).