Khodakarami Nima, Akinlotan Marvellous, Ferdinand Alva O
Department of Health Policy and Administration, Penn State University, Monaca, PA, USA.
Center for Applied Studies in Health Economics, College of Medicine, Penn State University, Hershey, PA, USA.
Public Health Rep. 2025 Aug 31:333549251361324. doi: 10.1177/00333549251361324.
Despite growing interest in environmental and social determinants of health, few studies have explored how residential mobility influences respiratory health outcomes. We examined the relationship between levels of opportunity across education, health and environment, social and economic, and all domains in a child's neighborhood and the likelihood of emergency department (ED) visits for asthma and showed how moving from one neighborhood to another would affect the odds of visiting the ED for asthma.
In this cross-sectional study, we analyzed asthma-related ED visits among children aged 2 to 17 years in 9 US states (Arizona, Florida, Kentucky, Maryland, New Jersey, North Carolina, Oregon, Rhode Island, and Wisconsin) during 2016-2019. We used a multivariable logistic regression model to examine the relationship between the Child Opportunity Index (COI) and ED visits for asthma. We used a piecewise linear logit model to estimate the neighborhood's opportunity effect.
Children living in neighborhoods with very low COI had a high probability of visiting the ED for asthma (adjusted odd ratio = 1.14; < .001). In addition, moving from a low to a very low COI neighborhood significantly increased the probability of asthma-related ED visits among children aged 5 to 9 years (0.8 percentage points), Black children (0.4 percentage points), boys (0.7 percentage points), and those living in large metropolitan areas (0.6 percentage points).
Our findings suggest that improvement in neighborhood opportunity may translate to better asthma-related health outcomes among children. Future research should continue to investigate the effects of neighborhood opportunity on other childhood conditions.
尽管人们对健康的环境和社会决定因素的兴趣日益浓厚，但很少有研究探讨居住流动性如何影响呼吸健康结果。我们研究了儿童社区在教育、健康与环境、社会与经济以及所有领域的机会水平与因哮喘前往急诊科就诊可能性之间的关系，并展示了从一个社区搬到另一个社区如何影响因哮喘前往急诊科就诊的几率。
在这项横断面研究中，我们分析了2016 - 2019年期间美国9个州（亚利桑那州、佛罗里达州、肯塔基州、马里兰州、新泽西州、北卡罗来纳州、俄勒冈州、罗德岛州和威斯康星州）2至17岁儿童与哮喘相关的急诊科就诊情况。我们使用多变量逻辑回归模型来研究儿童机会指数（COI）与因哮喘前往急诊科就诊之间的关系。我们使用分段线性逻辑模型来估计社区的机会效应。
生活在COI非常低的社区的儿童因哮喘前往急诊科就诊的可能性很高（调整后的比值比 = 1.14；< 0.001）。此外，从COI低的社区搬到COI非常低的社区，显著增加了5至9岁儿童（0.8个百分点）、黑人儿童（0.4个百分点）、男孩（0.7个百分点）以及生活在大都市区的儿童（0.6个百分点）因哮喘前往急诊科就诊的概率。
我们的研究结果表明，社区机会的改善可能转化为儿童更好的与哮喘相关的健康结果。未来的研究应继续调查社区机会对其他儿童疾病的影响。
