R A Zárate1, Corwin Zigler2, Catherine Cubbin3, Elizabeth C Matsui4. 1. Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Tex. 2. Department of Women's Health, Dell Medical School, University of Texas at Austin, Austin, Tex; Department of Statistics and Data Sciences, University of Texas at Austin, Austin, Tex. 3. Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Tex; Steve Hicks School of Social Work, University of Texas at Austin, Austin, Tex. 4. Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Tex; Steve Hicks School of Social Work, University of Texas at Austin, Austin, Tex; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Tex. Electronic address: ematsui@utexas.edu.
Abstract
BACKGROUND: The extent to which asthma-related emergency department (ED) visit incidence rates vary from neighborhood to neighborhood and the predictors of neighorbood-level asthma ED visit burden are not well understood. OBJECTIVE: Our aim was 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 Travis County, Texas, 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 that 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 smaller spatial scales than previously examined. 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 features. Race/ethnicity-specific estimates of neighborhood ED visit rates may be useful for identifying high-burden neighborhoods for specific ethnic and racial groups that otherwise would go unrecognized.
BACKGROUND: The extent to which asthma-related emergency department (ED) visit incidence rates vary from neighborhood to neighborhood and the predictors of neighorbood-level asthma ED visit burden are not well understood. OBJECTIVE: Our aim was 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 Travis County, Texas, 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 that 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 smaller spatial scales than previously examined. 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 features. Race/ethnicity-specific estimates of neighborhood ED visit rates may be useful for identifying high-burden neighborhoods for specific ethnic and racial groups that otherwise would go unrecognized.
Authors: Omar Olmedo; Inge F Goldstein; Luis Acosta; Adnan Divjan; Andrew G Rundle; Ginger L Chew; Robert B Mellins; Lori Hoepner; Howard Andrews; Sara Lopez-Pintado; James W Quinn; Frederica P Perera; Rachel L Miller; Judith S Jacobson; Matthew S Perzanowski Journal: J Allergy Clin Immunol Date: 2011-05-04 Impact factor: 10.793
Authors: Lindsay E Brown; Ryan Burton; Brian Hixon; Manasi Kakade; Parul Bhagalia; Catherine Vick; Andrew Edwards; Mary T Hawn Journal: West J Emerg Med Date: 2012-11