De La Cruz Noah, Hines Jonathon H, Shaw Chip, Appiah Duke
College of Osteopathic Medicine, Sam Houston State University, Conroe, USA.
Public Health, Texas Tech University Health Sciences Center, Lubbock, USA.
Cureus. 2021 Nov 29;13(11):e20015. doi: 10.7759/cureus.20015. eCollection 2021 Nov.
Background In the United States, asthma is the most common chronic disease in children, and is associated with low sociodemographic, economic, and environmental factors. Objective To investigate geographic disparities in asthma hospitalizations and the roles that race/ethnicity, health insurance, and other environmental factors played on these disparities in Lubbock County, Texas. Methods Data were obtained from the Texas Inpatient Public Use Data File for the years 1999-2018. International classification of disease codes were used to identify primary diagnoses of asthma among all severe inpatient admissions. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 248,768 patients admitted for severe conditions, 4,224 had a primary diagnosis of asthma. In multivariable-adjusted models, the odds of asthma hospitalizations varied across geographic regions of Lubbock with the Northeast having the highest age-adjusted prevalence (7.17 per 1,000) and ORs for asthma hospitalizations (OR: 1.25, CI: 1.12-1.40). Data suggested that non-Hispanic Blacks using federal insurance in the Northeast region had the highest odds for asthma hospitalizations (OR: 4.88, CI: 3.06-7.79; p-interaction = 0.001). Across all regions, a 1 μg/m increase in particulate matter 2.5 was associated with a 27% higher likelihood of asthma hospitalization (OR: 1.27, 95% CI: 1.23-1.31). Conclusion In this study, geographic disparities in asthma hospitalizations were observed within Lubbock County and were significantly influenced by a disparate distribution of socioeconomic factors related to health insurance and race/ethnicity. The potential contributory role of particulate matter needs further investigation.
在美国，哮喘是儿童中最常见的慢性疾病，且与社会人口统计学、经济和环境等方面的低水平因素相关。目的：调查得克萨斯州拉伯克县哮喘住院情况的地域差异，以及种族/民族、医疗保险和其他环境因素在这些差异中所起的作用。方法：数据取自1999 - 2018年得克萨斯州住院患者公共使用数据文件。使用国际疾病分类代码来识别所有重症住院患者中的哮喘主要诊断。采用逻辑回归来估计比值比（OR）和95%置信区间（CI）。结果：在248,768例因重症入院的患者中，4224例主要诊断为哮喘。在多变量调整模型中，拉伯克不同地理区域的哮喘住院几率有所不同，东北部年龄调整患病率最高（每1000人中有7.17例），哮喘住院的OR值（OR：1.25，CI：1.12 - 1.40）。数据表明，在东北部地区使用联邦保险的非西班牙裔黑人哮喘住院几率最高（OR：4.88，CI：3.06 - 7.79；p交互作用 = 0.001）。在所有地区，细颗粒物2.5每增加1μg/m，哮喘住院的可能性就会增加27%（OR：1.27，95%CI：1.23 - 1.31）。结论：在本研究中，拉伯克县内观察到哮喘住院情况存在地域差异，且受到与医疗保险和种族/民族相关的社会经济因素分布不均的显著影响。细颗粒物的潜在促成作用需要进一步研究。
