The following is a summary of “Understanding racial disparities in childhood asthma using individual- and neighborhood-level risk factors,” published in the December 01, 2022 issue of Allergy and Clinical Immunology by Correa-Agudelo, et al.
Children with asthma were more likely to experience racial differences in outcomes due to a complex interaction of community and individual-level variables. African American (AA) and European American (EA) children’s emergency department (ED) visits for asthma-related symptoms were the subjects of the investigation.
In the retrospective analysis, individuals under the age of 18 who sought treatment for asthma at Cincinnati Children’s ED between 2009 and 2018 are included. The result was the total number of ED visits in a given year. 11 social, economic, and environmental factors were evaluated. The connections between race, mediators, and the quantity of ED visits were evaluated using mediation and mixed-effects models.
A total of 31,114 kids (46.1% AA, 53.9% EA) visited emergency rooms due to asthma. Children in AA received more visits annually (2.23 vs. 2.15; P< .001) than children in EA. Compared to commercial insurance, Medicaid insurance was linked to a 7% increase in the rate of ED visits (1.07; 95% CI, 1.03-1.1). For AA children but not for EA children, neighborhood socioeconomic hardship was linked to a higher prevalence of ED visits. Both AA and EA children visited the ED more frequently when exposed to outdoor mold, pollen, and area-level particulate matter with a diameter smaller than 2.5 μm (all P <.001). Insurance, local deprivation, particulate matter with a diameter smaller than 2.5 μm, and outdoor mold (all P< .001) all acted as mediators between race and the frequency of ED visits, and collectively they accounted for 55% of the influence of race on ED visits. After controlling for mediators; the race was not linked with the frequency of ED visits (P =.796).
Social, economic, and environmental variables that may be susceptible to interventions targeted at improving outcomes and eradicating injustices affect racial differences in asthma-related ED visits.