1
|
Zárate RA, Bhavnani D, Chambliss S, Hall EM, Zigler C, Cubbin C, Wilkinson M, Matsui EC. Neighborhood-level variability in asthma-related emergency department visits in Central Texas. J Allergy Clin Immunol 2024:S0091-6749(24)00568-2. [PMID: 38851399 DOI: 10.1016/j.jaci.2024.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/15/2024] [Accepted: 05/17/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND The extent to which incidence rates of asthma-related emergency department (ED) visits vary from neighborhood to neighborhood and predictors of neighborhood-level asthma ED visit burden are not well understood. OBJECTIVE We aimed to describe the census tract-level spatial distribution of asthma-related ED visits in Central Texas and identify neighborhood-level characteristics that explain variability in neighborhood-level asthma ED visit rates. METHODS Conditional autoregressive models were used to examine the spatial distribution of asthma-related ED visit incidence rates across census tracts in Travis County, Texas, and assess the contribution of census tract characteristics to their distribution. RESULTS There were distinct patterns in ED visit incidence rates at the census tract scale. These patterns were largely unexplained by socioeconomic or selected built environment neighborhood characteristics. However, racial and ethnic composition explained 33% of the variability of ED visit incidence rates across census tracts. The census tract predictors of ED visit incidence rates differed by racial and ethnic group. CONCLUSIONS Variability in asthma ED visit incidence rates are apparent at smaller spatial scales. Most of the variability in census tract-level asthma ED visit rates in Central Texas is not explained by racial and ethnic composition or other neighborhood characteristics.
Collapse
Affiliation(s)
- Rebecca A Zárate
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Tex; Center for Health and Environment: Education and Research, Dell Medical School, University of Texas at Austin, Austin, Tex
| | - Darlene Bhavnani
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Tex; Center for Health and Environment: Education and Research, Dell Medical School, University of Texas at Austin, Austin, Tex
| | - Sarah Chambliss
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Tex; Center for Health and Environment: Education and Research, Dell Medical School, University of Texas at Austin, Austin, Tex
| | - Emily M Hall
- Center for Health and Environment: Education and Research, Dell Medical School, University of Texas at Austin, Austin, Tex; Department of Women's Health, Dell Medical School, University of Texas at Austin, Austin, Tex
| | - Corwin Zigler
- Center for Health and Environment: Education and Research, Dell Medical School, University of Texas at Austin, Austin, Tex; Department of Statistics and Data Sciences, University of Texas at Austin, Austin, Tex
| | - Catherine Cubbin
- Center for Health and Environment: Education and Research, Dell Medical School, University of Texas at Austin, Austin, Tex; Steve Hicks School of Social Work, University of Texas at Austin, Austin, Tex
| | - Matthew Wilkinson
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Tex
| | - Elizabeth C Matsui
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Tex; Center for Health and Environment: Education and Research, Dell Medical School, University of Texas at Austin, Austin, Tex; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Tex.
| |
Collapse
|
2
|
Zárate RA, Zigler C, Cubbin C, Matsui EC. RETRACTED: Neighborhood-level variability in asthma-related emergency department visits in Central Texas. J Allergy Clin Immunol 2021; 148:1262-1269.e6. [PMID: 34506851 PMCID: PMC8578425 DOI: 10.1016/j.jaci.2021.07.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022]
Abstract
Background: The extent to which asthma-related ED visit incidence rates vary from neighborhood to neighborhood and predictors of neighorbood-level asthma ED visit burden are not well understood. Objective: To describe the census tract-level spatial distribution of asthma-related emergency department visits in Central Texas and identify neighborhood-level characteristics that explain variability in neighborhood-level asthma ED visit rates. Methods: Conditional autoregressive models were used to examine the spatial distribution of asthma-related ED visit incidence rates across Travis County, TX census tracts and to assess the contribution of census tract characteristics to their distribution. Results: There were distinct patterns in ED visit incidence rates at the census tract scale, which were largely unexplained by socioeconomic or selected built environment neighborhood characteristics. Racial and ethnic composition explained 33% of the variability of ED visit incidence rates across census tracts. Spatial patterns and the census tract predictors of ED visit incidence rates differed by racial and ethnic groups. Conclusions: Variability in asthma ED visit incidence rates are apparent at a smaller spatial scales than previously examined. The majority of the variability in census tract-level asthma ED visit rates in Central Texas is not explained by racial and ethnic composition or other neighborhood features. Race/ethnicity-specific estimates of neighborhood ED visit rates may be useful for identifying high burden neighborhoods for specific ethnic/racial groups, which otherwise would go unrecognized. Asthma ED visit rates may vary among neighborhoods; neighborhood-level interventions or moving to a low incidence neighborhood may be effective in reducing asthma disparities and deserve further study.
Collapse
Affiliation(s)
- R. A. Zárate
- Department of Population Health, Dell Medical School at the University of Texas at Austin
| | - Corwin Zigler
- Department of Women’s Health, Dell Medical School at the University of Texas at Austin
- Department of Statistics and Data Sciences at the University of Texas at Austin
| | - Catherine Cubbin
- Department of Population Health, Dell Medical School at the University of Texas at Austin
- Steve Hicks School of Social Work, University of Texas at Austin
| | - Elizabeth C. Matsui
- Department of Population Health, Dell Medical School at the University of Texas at Austin
- Steve Hicks School of Social Work, University of Texas at Austin
- Department of Pediatrics, Dell Medical School at the University of Texas at Austin
| |
Collapse
|