A child's home address may be enough information to identify children and families at risk for more severe cases of asthma due to social and economic hardships. In fact, the home address could guide risk assessment starting the moment a family arrives and registers in the hospital or at the doctor's office.
While socioeconomic hardship is common in children hospitalized with asthma, a new Cincinnati Children's Hospital Medical Center study indicates that the patient's address is a reliable addition to or substitute for universal screening in identifying at-risk children and allocating resources more efficiently.
The study is published online in the journal Academic Pediatrics.
"Inequalities in pediatric asthma-related illness are largely driven by socioeconomic hardships and other social determinants of health, and children hospitalized with asthma are disproportionately from disadvantaged backgrounds and neighborhoods," says Katherine Auger, MD, a physician in the division of Hospital Medicine at Cincinnati Children's and lead author of the study. "Universal implementation of social support interventions may be cost prohibitive, but bringing this information to the clinical team could be beneficial in targeting and allocating resources more effectively."
The researchers studied 774 children hospitalized with asthma whose caregivers answered questions regarding income, financial strain and access to primary care as part of the Greater Cincinnati Asthma Risks Study. Addresses were geocoded or mapped and linked to zip code, census tract and census block group data - statistical divisions of census tracts. Area-level measures of income were significantly associated with caregiver-reported income, poverty was significantly associated with financial strain, and vehicle availability was significantly associated with access to care.
The study population was 57 percent African American and 73 percent publicly insured. Sixty-three percent reported income of less than $30,000 annually, 32 percent indicated significant financial strain and 38 percent reported less than adequate primary care access.
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The study was funded by grants from the National Institutes of Health, (1R01AI88116) and (1K23AI112916).
About Cincinnati Children's
Cincinnati Children's, a non-profit, pediatric, academic medical center established in 1883, is internationally recognized for improving child health and transforming delivery of care through fully integrated, globally recognized research, education and innovation. It is one of the top three recipients of pediatric research grants from the National Institutes of Health, ranked third in the nation among all Honor Roll hospitals in U.S. News and World Report's Best Children's Hospitals, and a research and teaching affiliate of the University of Cincinnati's College of Medicine. Its patient population includes the eight-county primary service area covering parts of Ohio, Kentucky and Indiana. A destination for children with complex medical conditions, it also served patients from all 50 states and nearly 70 countries during the past year. Additional information can be found at http://www.cincinnatichildrens.org. Connect on the Cincinnati Children's blog, via Facebook and on Twitter.
Journal
Academic Pediatrics