Social determinants of health (SDOH), including decreased educational attainment, are associated with at-risk rates (ARRs) for ED encounter and hospitalization among children with asthma, according to a study published in Pediatrics. Jordan Tyris, MD, and colleagues conducted a population based cross-sectional study involving children with asthma aged 2-17 living in the District of Columbia (DC). For each DC census tract, ED encounter and hospitalization ARRs were calculated. Using the Healthy People 2030 SDOH framework, five census-tract variables (exposures) were selected: educational attainment, vacant housing, violent crime, limited English proficiency, and families living in poverty. From January 2018 to December 2019, 4,321 children had 7,515 ED encounters and 1,182 children had 1,588 hospitalizations. Across census tracts, ARRs varied 10-fold for ED encounters and hospitalizations (64-728 and 20-240 per 1,000 children with asthma, respectively). Reduced educational attainment was significantly associated with ARRs for ED encounters and hospitalizations in adjusted analyses. There was a significant association seen for violent crime with ARRs for ED encounters.

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