Geiger Sarah Dee, Khaium M Omar, Gustafson Evan M, Shapiro Marcus, Keeley Sarah, Johnson Cassandra, Amerson Nancy, Lee Daniel, Gerald Lynn B, Keddie Arlene
Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Champaign, IL, United States.
Southern Illinois University School of Medicine, Springfield, IL, United States.
Front Public Health. 2025 Feb 26;13:1521545. doi: 10.3389/fpubh.2025.1521545. eCollection 2025.
This ecologic study explores the relationship between the Social Vulnerability Index (SVI) and probable asthma-related emergency medical service (EMS) rates before and during the COVID-19 pandemic at the county level in Illinois.
The number of asthma-related EMS visits was obtained in all 102 counties for adults aged 18 years or more, and for 82 of these counties for children aged less than 18 from 2018 to 2021. They were converted into rates and examined in relation to SVI rankings. Pearson's correlation coefficients and negative binomial regression were used to examine associations, adjusting for the level of rurality.
The rate of asthma-related EMS visits increased in adults from 23.1 to 28.9 per 1,000 between 2018 and 2021 but decreased in children from 5.9 to 5 per 1,000. Every 1% increase in the overall SVI was associated with a nearly two-fold increase in the rate of EMS visits in adults (pre-COVID-19: IRR = 1.94, < 0.01; during-COVID: IRR = 1.90, < 0.01) and an even greater increase in children (pre-COVID-19: IRR = 2.61, < 0.01; during-COVID: IRR = 2.92, < 0.01) Consistent associations were found for the SVI themes of socioeconomic status, housing type, and transportation across age groups and time periods.
During the pandemic, all four themes of SVI were associated with the asthma EMS rate in children. This study has shown that the same factors that lead to community vulnerability in a disaster align with a greater need for on-site asthma emergency treatment.
本生态研究探讨了伊利诺伊州县级层面社会脆弱性指数（SVI）与2019年冠状病毒病（COVID-19）大流行之前及期间可能与哮喘相关的紧急医疗服务（EMS）发生率之间的关系。
获取了2018年至2021年伊利诺伊州所有102个县18岁及以上成年人以及其中82个县18岁以下儿童与哮喘相关的EMS就诊次数。将其转换为发生率，并根据SVI排名进行检查。使用Pearson相关系数和负二项回归来检验关联，并对农村程度进行调整。
2018年至2021年期间，成年人中与哮喘相关的EMS就诊率从每1000人23.1次增加到28.9次，但儿童中该就诊率从每1000人5.9次降至5次。总体SVI每增加1%，成年人的EMS就诊率几乎增加两倍（COVID-19之前：发病率比值比[IRR]=1.94，P<0.01；COVID期间：IRR=1.90，P<0.01），儿童的增加幅度更大（COVID-19之前：IRR=2.61，P<0.01；COVID期间：IRR=2.92，P<0.01）。在不同年龄组和时间段内，SVI的社会经济地位、住房类型和交通等主题均存在一致的关联。
在大流行期间，SVI的所有四个主题均与儿童哮喘EMS发生率相关。本研究表明，导致社区在灾难中脆弱的相同因素与现场哮喘紧急治疗的更大需求相关。
