Social and built environmental factors associated with adult asthma hospital admission in the North Central Texas

Abstract

Asthma, one of the most common chronic diseases of adults and children, is an important public health concern. The cause of asthma is thought to be a combination of genetic and environmental factors, and a growing body of research has investigated the possible geographic and contextual factors that contribute to asthma prevalence. However, few studies have incorporated geographic and environmental variables into their designs, despite evidence that geography is associated with asthma exacerbation. Additionally, studies of asthma exacerbations among adults are limited. The situation regarding asthma is particularly concerning in North Central Texas (NCT) compared to the national context. In light of this, we analyzed the geographic variation of approximately 12,000 adult patients hospitalized for asthma in the North Central Texas Region, and their association with built environmental features such as land use types, dwelling characteristics, exposure to traffic parameters at the Census Block Group (CBG) level, and pollutant concentrations in the relevant counties for the year 2014. We applied the Hierarchical Linear Model (HLM), and our analysis indicates that there are significant health disparities in the region. We found that the adult asthma hospitalization rate is significantly higher in low-income, low-education neighborhoods with a significant Black population. Furthermore, factors such as increased travel distance to work and substandard dwelling conditions have been found to trigger an increase in hospital visits for asthma patients. Conversely, the presence of greenspace in the surrounding area has been found to help reduce the frequency of asthma-related hospital visits. It is worth noting that both indoor and outdoor environmental quality contribute to adult asthma hospitalizations. Overall, our study highlights the importance of considering geographic and environmental factors in understanding the prevalence and exacerbation of asthma. Our findings suggest that targeted interventions, such as improving indoor and outdoor environmental quality and increasing access to greenspace, may help reduce the burden of asthma in high-risk communities.