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Pediatric population size is associated with geographic patterns of acute respiratory infections among adults

John S Brownstein1, Kenneth D Mandl

  • 1Division of Emergency Medicine, Children's Hospital Boston; Children's Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology, Boston, MA 02215, USA. john_brownstein@harvard.edu

Annals of Emergency Medicine
|April 1, 2008
PubMed

Insights

The proportion of children in a community is linked to when and how often adults use emergency departments for respiratory infections. Younger children, particularly 3- to 4-year-olds, significantly influence adult illness patterns and onset timing.

Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Disease Transmission

Background:

  • Adult emergency department (ED) utilization for acute respiratory infections (ARIs) is a significant public health concern.
  • Understanding community-level factors influencing ARI transmission is crucial for effective public health interventions.

Purpose of the Study:

  • To investigate the association between the proportion of children in a population and the timing and rate of adult ED visits for influenza and other ARIs.
  • To identify specific pediatric age groups that may be key drivers of community-wide ARI transmission.

Main Methods:

  • An ecologic time-series study was conducted using adult ED visit data from Massachusetts (2001-2005).
  • ARI-related ED visits were aggregated by ZIP code and correlated with US Census pediatric population data.
  • Poisson regression analysis was employed to assess the relationship between pediatric population proportions and adult ARI ED utilization.

Main Results:

  • Over 157,000 adult ARI-related ED visits were analyzed.
  • A higher proportion of children in a ZIP code was directly associated with earlier seasonal onset of adult ARIs (RR 0.985) and increased adult ARI ED utilization rates (RR 1.035).
  • The 3- to 4-year-old age group emerged as the most significant predictor for adult illness rates and timing of onset.

Conclusions:

  • A positive correlation exists between the proportion of children in a community and adult ED utilization for ARIs.
  • Findings support the critical role of children in the community-wide transmission of acute respiratory infections.
  • This highlights the importance of considering pediatric populations in public health strategies for managing infectious diseases.
Abstract

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