Beck Andrew F, Huang Bin, Chundur Raj, Kahn Robert S
Andrew F. Beck (
Bin Huang is an associate professor of pediatrics at Cincinnati Children's Hospital Medical Center.
Health Aff (Millwood). 2014 Nov;33(11):1993-2002. doi: 10.1377/hlthaff.2014.0496.
Local agencies that enforce housing policies can partner with the health care system to target pediatric asthma care. These agencies retain data that can be used to pinpoint potential clusters of high asthma morbidity. We sought to assess whether the density of housing code violations in census tracts-the in-tract asthma-relevant violations (such as the presence of mold or cockroaches) divided by the number of housing units-was associated with population-level asthma morbidity and could be used to predict a hospitalized patient's risk of subsequent morbidity. We found that increased density in housing code violations was associated with population-level morbidity independent of poverty, and that the density explained 22 percent of the variation in rates of asthma-related emergency department visits and hospitalizations. Children who had been hospitalized for asthma had 1.84 greater odds of a revisit to the emergency department or a rehospitalization within twelve months if they lived in the highest quartile of housing code violation tracts, compared to those living in the lowest quartile. Integrating housing and health data could highlight at-risk areas and patients for targeted interventions.
执行住房政策的地方机构可以与医疗保健系统合作，以针对儿童哮喘护理。这些机构保存的数据可用于查明哮喘高发病率的潜在聚集区。我们试图评估人口普查区住房法规违规的密度（即区内与哮喘相关的违规行为，如霉菌或蟑螂的存在情况，除以住房单元数量）是否与人群层面的哮喘发病率相关，以及是否可用于预测住院患者随后发病的风险。我们发现，住房法规违规密度的增加与人群层面的发病率相关，且独立于贫困因素，该密度解释了哮喘相关急诊就诊率和住院率变化的22%。因哮喘住院的儿童，如果居住在住房法规违规率最高的四分位数区域，与居住在最低四分位数区域的儿童相比，在12个月内再次前往急诊科就诊或再次住院的几率高出1.84倍。整合住房和健康数据可以突出高风险地区和患者，以便进行有针对性的干预。
