Regional and racial disparities in asthma hospitalizations in Mississippi

Roy, Sitesh R.; McGinty, Emma E.; Hayes, Sandra C.; Zhang, Lei

doi:10.1016/j.jaci.2009.11.046

Cited by 28 publications

(18 citation statements)

References 26 publications

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“…However, published studies examining possible racial/ethnic variations in these factors among children with DS have been limited. In contrast, numerous studies have documented racial/ethnic differences in preventable hospitalizations for other chronic conditions such as asthma (e.g., Ash & Brandt, 2006; Crocker et al, 2009; Erickson, Iribarren, Tolstykh, Blanc, & Eisner, 2007; Jones, Lin, Munsie, Radigan, & Hwang, 2008; Laditka & Laditka, 2006; Lu & Kuo, 2012; Roy, McGinty, Hayes, & Zhang, 2010). …”

Section: Introductionmentioning

confidence: 98%

Racial/ethnic differences in hospital use and cost among a statewide population of children with Down syndrome

Derrington¹,

Kotelchuck²,

Plummer³

et al. 2013

Research in Developmental Disabilities

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Children with Down syndrome (DS) use hospital services more often than children without DS, but data on racial/ethnic variations are limited. This study generated population-based estimates of hospital use and cost to 3 years of age by race/ethnicity among children with DS in Massachusetts using birth certificates linked to birth defects registry and hospital discharge data from 1999 to 2004. Hospital use (≥1 post-birth hospitalization and median days hospitalized birth and post-birth) and reasons for hospitalization were compared across maternal race/ethnicity using relative risk (RR) and Wilcoxon rank sums tests, as appropriate. Costs were calculated in 2011 United States dollars. Greater hospital use was observed among children with DS with Hispanic vs. Non-Hispanic White (NHW) mothers (post-birth hospitalization: RR 1.4; median days hospitalized: 20.0 vs. 11.0, respectively). Children with DS and congenital heart defects of Non-Hispanic Black (NHB) mothers had significantly greater median days hospitalized than their NHW counterparts (24.0 vs. 16.0, respectively). Respiratory diagnoses were listed more often among children with Hispanic vs. NHW mothers (50.0% vs. 29.1%, respectively), and NHBs had more cardiac diagnoses (34.1% vs. 21.5%, respectively). The mean total hospital cost was nine times higher among children with DS ($40,075) than among children without DS ($4053), and total costs attributable to DS were almost $18 million. Median costs were $22,781 for Hispanics, $18,495 for NHBs, and $13,947 for NHWs. Public health interventions should address the higher rates of hospital use and hospitalizations for respiratory and cardiac diseases among racial/ethnic minority children with DS in Massachusetts.

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Section: Introductionmentioning

confidence: 98%

Racial/ethnic differences in hospital use and cost among a statewide population of children with Down syndrome

Derrington¹,

Kotelchuck²,

Plummer³

et al. 2013

Research in Developmental Disabilities

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“…13 An analysis of hospital discharge information from Mississippi found an increased rate of emergency department care and hospitalization for asthma among residents of the rural Mississippi delta compared with metropolitan Jackson, and this difference persisted after controlling for covariates. 14 …”

Section: Introductionmentioning

confidence: 99%

High asthma prevalence and increased morbidity among rural children in a Medicaid cohort

Valet

Gebretsadik

Carroll

et al. 2011

Annals of Allergy, Asthma & Immunology

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Background Urban children represent a group at high risk for asthma development and adverse asthma outcomes. Although rural children also encounter sociodemographic disparities that might be expected to worsen asthma, asthma in the rural US is poorly studied. Objectives To determine rural-urban differences in childhood asthma diagnosis and morbidity. Methods We studied a statewide population of 117,080 children continuously enrolled in Tennessee Medicaid from birth through the sixth year of life, using linked Tennessee Medicaid, vital records, and pharmacy claims databases to determine asthma diagnosis and residence. Results The cohort was 45% urban, 23% suburban, and 33% rural. Compared with urban children, rural children were more likely to be white, have a history of bronchiolitis, and have mothers who smoked. Eleven percent of urban, 12% of suburban, and 13% of rural children met study criteria for asthma diagnosis (adjusted odds ratio [OR] for rural children 1.16, 95% confidence interval [CI] 1.09–1.24, and for suburban children adjusted OR 1.22, 95% CI 1.14–1.30, with urban as referent, P<0.001). Rural children had greater utilization of outpatient asthma care, whereas urban children had greater utilization of inhaled corticosteroids. Compared with urban children, rural children had fewer asthma ED visits, but were hospitalized for asthma at similar rates. Others markers of asthma control, including oral corticosteroid and short acting beta agonist usage, were similar between rural and urban children. CONCLUSION In this pediatric Medicaid population, rural children had increased asthma prevalence, similar asthma morbidity, and differences in patterns of asthma care and resource utilization compared with urban children.

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“…A recent study in Mississippi found asthma hospitalisation rates to be significantly higher among all demographic groups in the rural Delta region compared with the urban Jackson metropolitan statistical area, but with the highest rates among blacks and females in both regions (Roy et al, 2010). Block group level demographic data from the ESRI Tapestry dataset (ESRI, 2010), based on the USA Census Bureau, were used for GeoMedStat.…”

Section: Demographic Datamentioning

confidence: 99%

GeoMedStat: an integrated spatial surveillance system to track air pollution and associated healthcare events

Faruque

Li²,

Williams

et al. 2014

Geospat Health

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Abstract. Air pollutants, such as particulate matter with a diameter ≤2.5 microns (PM2.5) and ozone (O3), are known to exacerbate asthma and other respiratory diseases. An integrated surveillance system that tracks such air pollutants and associated disease incidence can assist in risk assessment, healthcare preparedness and public awareness. However, the implementation of such an integrated environmental health surveillance system is a challenge due to the disparate sources of many types of data and the implementation becomes even more complicated for a spatial and real-time system due to lack of standardised technological components and data incompatibility. In addition, accessing and utilising health data that are considered as Protected Health Information (PHI) require maintaining stringent protocols, which have to be supported by the system. This paper aims to illustrate the development of a spatial surveillance system (GeoMedStat) that is capable of tracking daily environmental pollutants along with both daily and historical patient encounter data. It utilises satellite data and the groundmonitor data from the US National Aeronautics and Space Administration (NASA) and the US Environemental Protection Agenecy (EPA), rspectively as inputs estimating air pollutants and is linked to hospital information systems for accessing chief complaints and disease classification codes. The components, developmental methods, functionality of GeoMedStat and its use as a real-time environmental health surveillance system for asthma and other respiratory syndromes in connection with with PM 2.5 and ozone are described. It is expected that the framework presented will serve as an example to others developing real-time spatial surveillance systems for pollutants and hospital visits.

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Regional and racial disparities in asthma hospitalizations in Mississippi

Cited by 28 publications

References 26 publications

Racial/ethnic differences in hospital use and cost among a statewide population of children with Down syndrome

Racial/ethnic differences in hospital use and cost among a statewide population of children with Down syndrome

High asthma prevalence and increased morbidity among rural children in a Medicaid cohort

GeoMedStat: an integrated spatial surveillance system to track air pollution and associated healthcare events

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