Mapping emergency department asthma visits to identify poor-quality housing in New Haven, CT, USA: a retrospective cohort study

Autor: Elizabeth A, Samuels, Richard Andrew, Taylor, Akshay, Pendyal, Abbas, Shojaee, Anne S, Mainardi, Evan R, Lemire, Arjun K, Venkatesh, Steven L, Bernstein, Adam L, Haber
Rok vydání: 2022
Předmět:
Zdroj: The Lancet Public Health. 7:e694-e704
ISSN: 2468-2667
DOI: 10.1016/s2468-2667(22)00143-8
Popis: Housing conditions are a key driver of asthma incidence and severity. Previous studies have shown increased emergency department visits for asthma among residents living in poor-quality housing. Interventions to improve housing conditions have been shown to reduce emergency department visits for asthma, but identification and remediation of poor housing conditions is often delayed or does not occur. This study evaluates whether emergency department visits for asthma can be used to identify poor-quality housing to support proactive and early intervention.We conducted a retrospective cohort study of children and adults living in and around New Haven, CT, USA, who were seen for asthma in an urban, tertiary emergency department between March 1, 2013, and Aug 31, 2017. We geocoded and mapped patient addresses to city parcels, and calculated a composite estimate of the incidence of emergency department use for asthma for each parcel (N11 429 asthma-related emergency department visits from 6366 unique patients were included in the analysis. Mean patient age was 32·4 years (SD 12·8); 3836 (60·3%) patients were female, 2530 (39·7%) were male, 3461 (57·2%) were Medicaid-insured, and 2651 (41·6%) were Black. Incidence of emergency department use for asthma was strongly correlated with lower housing inspection scores (Pearson's r=-0·55 [95% CI -0·70 to -0·35], p=3·5 × 10Emergency department visits for asthma are an early indicator of failed housing inspections. This approach represents a novel method for the early identification of poor housing conditions and could help to reduce asthma-related morbidity and mortality.Harvard-National Institute of Environmental Health Sciences (NIEHS) Center for Environmental Health.
Databáze: OpenAIRE