A novel tool using social and environmental determinants of health to assess pediatric asthma in the emergency department.

Autor: Liberman DB; Division of Emergency and Transport Medicine Children's Hospital Los Angeles Los Angeles California USA.; Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles California USA.; Department of Population and Public Health Sciences, Keck School of Medicine University of Southern Los Angeles California USA., Tam JS; Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles California USA.; Division of Clinical Immunology and Allergy Children's Hospital Los Angeles Los Angeles California USA., Cushing AM; Division of Emergency and Transport Medicine Children's Hospital Los Angeles Los Angeles California USA.; Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles California USA., Espinoza J; Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles California USA.; Division of General Pediatrics Children's Hospital Los Angeles Los Angeles California USA.
Jazyk: angličtina
Zdroj: Journal of the American College of Emergency Physicians open [J Am Coll Emerg Physicians Open] 2024 Aug 14; Vol. 5 (4), pp. e13240. Date of Electronic Publication: 2024 Aug 14 (Print Publication: 2024).
DOI: 10.1002/emp2.13240
Abstrakt: Asthma, the most common chronic disease in children, affects more than 4 million children in the United States, disproportionately affecting those who are economically disadvantaged and racial and ethnic minorities. Studies have shown that the racial and ethnic disparities in asthma outcomes can be largely explained by environmental, socioeconomic and other social determinants of health (SDoH). Utilizing new approaches to stratify disease severity and risk, which focus on the underlying SDoH that lead to asthma disparity, provides an opportunity to disentangle race and ethnicity from its confounding social determinants. In particular, with the growing use of geospatial information systems, geocoded data can enable researchers and clinicians to quantify social and environmental impacts of structural racism. When these data are systematically collected and tabulated, researchers, and ultimately clinicians at the bedside, can evaluate patients' neighborhood context and create targeted interventions toward those factors most associated with asthma morbidity. To do this, we have designed a view (mPage in the Cerner electronic health record) that centralizes key clinical information and displays it alongside SDoH variables shown to be linked to asthma incidence and severity. Once refined and validated, which is the next step in our project, our goal is for emergency medicine clinicians to use these data in real time while caring for patients with asthma. Our multidisciplinary, patient-centered approach that leverages modern informatics tools will create opportunities to better triage patients with asthma exacerbations, choose the best interventions, and target underlying determinants of disease.
Competing Interests: The authors declare no conflicts of interest.
(© 2024 The Author(s). Journal of the American College of Emergency Physicians Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)
Databáze: MEDLINE
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