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住房质量对西班牙裔/拉丁裔集中贫困和与哮喘相关的急诊科就诊的调节作用。

The moderating role of housing quality on concentrated poverty and asthma-related emergency department visits among Hispanics/Latinos.

机构信息

Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA.

Central Valley Health Policy Institute, College of Health and Human Services, California State University, Fresno, CA, USA.

出版信息

J Asthma. 2023 Oct;60(10):1816-1823. doi: 10.1080/02770903.2023.2188567. Epub 2023 Mar 29.

Abstract

BACKGROUND

Rates of asthma-related emergency department visits have been shown to vary significantly by place (i.e. neighborhood) and race/ethnicity. The moderating factors of asthmatic events among Hispanic/Latino-specific populations are known to a much lesser degree.

OBJECTIVE

To assess the extent to which housing moderates the effect of poverty on Hispanic/Latino-specific asthma-related emergency department (ED) visits at an ecological level.

METHODS

Using data from the Office of Statewide Health Planning and Development (OSHPD) and the 2016-2017 U.S. Census, a cross-sectional ecological analysis at the census tract-level was conducted. Crosswalk files from the U.S. Department of Housing and Urban Development were used to associate zip codes to census tracts. Negative binomial regression was used to estimate rate ratios.

RESULTS

The effect of poverty on asthma-related ED visits was significantly moderated by the median year of housing structures built. The effect of mid-level poverty (RR = 1.57, 95% CI 1.27, 1.95) and high-level poverty (RR = 1.47, 95% CI 1.22, 1.78) in comparison to low-level poverty, was significantly greater among census tracts with housing built prior to 1965 in comparison to census tract with housing built between 1965 and 2020.

CONCLUSION

Communities with older housing structures tend to be associated with increased Hispanic/Latino ED visits apart from affluent communities.

摘要

背景

已证实,哮喘相关急诊就诊率因地点(即社区)和种族/族裔而异。西班牙裔/拉丁裔特定人群中哮喘事件的调节因素在较小程度上是已知的。

目的

评估住房在多大程度上调节贫困对西班牙裔/拉丁裔特定哮喘相关急诊就诊的影响在生态水平上。

方法

使用来自州卫生规划与发展办公室(OSHPD)和 2016-2017 年美国人口普查的数据,在普查区层面进行了横断面生态分析。使用美国住房和城市发展部的交叉文件将邮政编码与普查区相关联。使用负二项回归估计比率比。

结果

贫困对哮喘相关急诊就诊的影响被住房结构建造的中位数年份显著调节。与低水平贫困相比,中低收入贫困(RR=1.57,95%CI 1.27,1.95)和高水平贫困(RR=1.47,95%CI 1.22,1.78)的影响在 1965 年前建造住房的普查区中明显更大,与 1965 年至 2020 年期间建造住房的普查区相比。

结论

除了富裕社区外,住房结构较旧的社区往往与西班牙裔/拉丁裔急诊就诊增加有关。

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