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Social Determinants of Emergency Department Visits in Mild Compared to Moderate and Severe Asthma

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A Correction to this article was published on 08 April 2022

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Abstract

Background

Social determinants of health (SDH) influence emergency department (ED) use among children with asthma. We aimed to examine if SDH were more strongly associated with ED use among children with moderate/severe compared to mild asthma.

Methods

This study utilized the 2016–2019 data from the National Survey of Children’s Health. Children with asthma ages 0–17 years (N = 9937) were included in the analysis. Asthma severity and all-cause ED use in the past year were reported by caregivers. The association between patient factors and ED visits was evaluated using ordinal logistic regression.

Results

Based on the study sample, 29% of children with asthma had moderate/severe asthma. In the mild group, 30% visited the ED at least once in the past 12 months, compared to 49% in the moderate/severe group. SDH associated with ED visits included race/ethnicity, insurance coverage, and parental educational attainment, but the strength of these associations did not vary according to asthma severity.

Conclusions

In a nationally representative data set, SDH were equally predictive of ED use regardless of children’s asthma severity. Interventions to reduce ED use among children with asthma should be considered for children with any severity of asthma, especially children in socially disadvantaged groups at higher risk of ED utilization.

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References

  1. "Reduce Emergency Department Visits For Children Under 5 Years With Asthma — RD-02 - Healthy People 2030 | Health.Gov". Health.Gov, 2021. https://health.gov/healthypeople/objectives-and-data/browse-objectives/respiratory-disease/reduce-emergency-department-visits-children-under-5-years-asthma-rd-02

  2. Gushue C, Miller R, Sheikh S, Allen ED, Tobias JD, Hayes D Jr, Tumin D (2019) Gaps in health insurance coverage and emergency department use among children with asthma. J Asthma 56(10):1070–1078

    Article  PubMed  Google Scholar 

  3. Zhang Q, Lamichhane R, Diggs LA (2017) Disparities in emergency department visits in American children with asthma: 2006–2010. J Asthma 54(7):679–686

    Article  PubMed  Google Scholar 

  4. Baltrus P, Xu J, Immergluck L, Gaglioti A, Adesokan A, Rust G (2017) Individual and county level predictors of asthma related emergency department visits among children on Medicaid: a multilevel approach. J Asthma 54(1):53–61

    Article  PubMed  Google Scholar 

  5. National Survey of Children’s Health [Internet]. https://www.childhealthdata.org/learn-about-the-nsch/NSCHsurveys. Accessed Jun 2021

  6. Rojanasarot S, Carlson AM, St Peter WL, Karaca-Mandic P, Wolfson J, Schommer JC (2020) Reducing potentially preventable health events among patients with asthma through multi-state, multi-center quality improvement program. J Asthma 27:1–9

    Google Scholar 

  7. Buckman C, Diaz AL, Tumin D, Bear K (2020) Parity and the association between maternal sociodemographic characteristics and breastfeeding. Breastfeed Med 15(7):443–452

    Article  PubMed  Google Scholar 

  8. Kim Y, Pirritano M, Parrish KM (2021) Determinants of racial and ethnic disparities in utilization of hospital-based care for asthma among Medi-Cal children in Los Angeles. J Asthma 30:1–10

    Article  CAS  Google Scholar 

  9. Ebell M, Marchello C, O’Connor J (2017) The burden and social determinants of asthma for adults in the state of Georgia. J Ga Public Health Assoc 6(4):426–434

    PubMed  PubMed Central  Google Scholar 

  10. Chung EK, Siegel BS, Garg A, Conroy K, Gross RS, Long DA, Lewis G, Osman CJ, Jo Messito M, Wade R Jr, Shonna Yin H, Cox J, Fierman AH (2016) Screening for social determinants of health among children and families living in poverty: a guide for clinicians. Curr Probl Pediatr Adolesc Health Care 46(5):135–153

    Article  PubMed  PubMed Central  Google Scholar 

  11. Horner SD (2020) Examining social determinants of health in childhood asthma management. Clin Nurse Spec 34(5):222–230

    Article  PubMed  PubMed Central  Google Scholar 

  12. McDowell KM, Kercsmar CM, Huang B, Guilbert TW, Kahn RS (2016) Medical and social determinants of health associated with intensive care admission for asthma in children. Ann Am Thorac Soc 13(7):1081–1088

    Article  PubMed  PubMed Central  Google Scholar 

  13. Spruce L (2019) Back to basics: social determinants of health. AORN J 110(1):60–69

    Article  PubMed  Google Scholar 

  14. Reno R, Hyder A (2018) The evidence base for social determinants of health as risk factors for infant mortality: a systematic scoping review. J Health Care Poor Underserv 29(4):1188–1208

    Article  Google Scholar 

  15. Snyder DA, Thomas OW, Gleeson SP, Stukus DR, Jones LM, Regan C, Shamansky A, Allen ED (2018) Reducing emergency department visits utilizing a primary care asthma specialty clinic in a high-risk patient population. J Asthma 55(7):785–794

    Article  PubMed  Google Scholar 

  16. Schechter SB, Lakhaney D, Peretz PJ, Matiz LA (2021) Community health worker intervention to address social determinants of health for children hospitalized with asthma. Hosp Pediatr 11:1370–1376

    Article  PubMed  Google Scholar 

  17. Crossingham I, Turner S, Ramakrishnan S, Fries A, Gowell M, Yasmin F, Richardson R, Webb P, O'Boyle E, Hinks TSC (2021) Combination fixed-dose β agonist and steroid inhaler as required for adults or children with mild asthma: a Cochrane systematic review. BMJ Evid Based Med

  18. Walters R, Leslie SJ, Polson R, Cusack T, Gorely T (2020) Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review. BMC Public Health 20(1):1040

    Article  PubMed  PubMed Central  Google Scholar 

  19. Chen E, Shalowitz MU, Story RE, Ehrlich KB, Manczak EM, Ham PJ, Le V, Miller GE (2017) Parents’ childhood socioeconomic circumstances are associated with their children’s asthma outcomes. J Allergy Clin Immunol 140(3):828-835.e2

    Article  PubMed  PubMed Central  Google Scholar 

  20. AAP: Practice tips: screening for basic and social needs and connecting families to community services 2020. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/poverty/Pages/practice-tips.aspx

  21. Hoque S, Goulding M, Hazeltine M, Ferrucci KA, Trivedi M, Liu SH (2022) Caregiver-perceived neighborhood safety and pediatric asthma severity: 2017–2018 National Survey of Children’s Health. Pediatr Pulmonol 57(2):376–385

    Article  PubMed  Google Scholar 

  22. Ross MK, Romero T, Szilagyi PG (2021) Adverse childhood experiences and association with pediatric asthma severity in the 2016–2017 National Survey of Children’s Health. Acad Pediatr 21(6):1025–1030

    Article  PubMed  Google Scholar 

  23. Aryee E, Perrin JM, Iannuzzi D, Kuhlthau KA, Oreskovic NM (2022) Association of neighborhood characteristics with pediatric asthma. Acad Pediatr. https://doi.org/10.1016/j.acap.2022.01.001

    Article  PubMed  Google Scholar 

  24. Kochis SR, Grant T, Phipatanakul W, Perzanowski M, Balcer-Whaley S, Curtin-Brosnan J, Newman M, Cunningham A, Bollinger ME, Matsui EC (2019) Caregiver-reported asthma control predicts future visits, independent of guideline-based control measures. J Allergy Clin Immunol Pract 7(5):1516–1521

    Article  PubMed  PubMed Central  Google Scholar 

  25. Chang L, Stewart AM, Monuteaux MC, Fleegler EW (2021) Neighborhood conditions and recurrent emergency department utilization by children in the United States. J Pediatr 234:115–122

    Article  PubMed  Google Scholar 

  26. Tumin D, Drees D, Miller R, Wrona S, Hayes D Jr, Tobias JD, Bhalla T (2018) Health care utilization and costs associated with pediatric chronic pain. J Pain 19(9):973–982

    Article  PubMed  Google Scholar 

  27. Szefler SJ (2018) Asthma across the lifespan: time for a paradigm shift. J Allergy Clin Immunol 142(3):773–780

    Article  PubMed  Google Scholar 

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA

    Kamel Alachraf & Caroline Currie

  2. Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA

    William Wooten & Dmitry Tumin

Authors
  1. Kamel Alachraf
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  2. Caroline Currie
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  3. William Wooten
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  4. Dmitry Tumin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Kamel Alachraf, Caroline Currie, Dmitry Tumin, and William Wooten. The first draft of the manuscript was written by Kamel Alachraf and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kamel Alachraf.

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The authors have no relevant financial or non-financial interests to disclose.

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The original online version of this article was revised: the incorrect copyright holder name was corrected.

Appendix

Appendix

See Table

Table 3 Unadjusted ordinal logistic regression models of emergency department visits, interacting each characteristic with asthma severity (N = 9937)
Full size table

3.

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Alachraf, K., Currie, C., Wooten, W. et al. Social Determinants of Emergency Department Visits in Mild Compared to Moderate and Severe Asthma. Lung 200, 221–226 (2022). https://doi.org/10.1007/s00408-022-00524-3

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  • DOI: https://doi.org/10.1007/s00408-022-00524-3

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