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Disparities in Preventable Hospitalizations Among Public Housing Developments
Brian Yim1, Renata E Howland1, Gretchen M Culp2
1Office of Policy, Planning and Strategic Data Use, New York City Department of Health and Mental Hygiene, New York, New York.
American Journal of Preventive Medicine
|December 17, 2018
Summary
Preventable hospitalizations are higher in New York City public housing residents compared to the general population, with significant variations across developments and conditions like diabetes and asthma.
Area of Science:
- Public Health
- Health Services Research
- Health Equity
Background:
- Preventable hospitalizations represent a significant burden on healthcare systems and indicate potential gaps in primary and ambulatory care access.
- New York City public housing residents may face unique socioeconomic and environmental factors contributing to health disparities.
- Understanding geographic variations in preventable hospitalization rates is crucial for targeted public health interventions.
Purpose of the Study:
- To assess and compare preventable hospitalization rates among New York City public housing residents versus the citywide and low-income populations.
- To identify specific ambulatory care-sensitive conditions contributing to these disparities.
- To examine the variability of preventable hospitalization rates across different public housing developments.
Main Methods:
- Utilized 2010-2014 New York City hospital discharge data, geocoded and linked with New York City Housing Authority records.
- Calculated age-adjusted preventable hospitalization rates for overall and 11 ambulatory care-sensitive conditions.
- Compared rates across public housing residents, citywide residents, low-income area residents, and by public housing development quartiles.
Main Results:
- Public housing residents had significantly higher age-adjusted preventable hospitalization rates compared to the citywide population (RR=2.67).
- The greatest disparities were observed for diabetes (RR=3.12) and asthma (RR=4.14) hospitalizations.
- Rates were also higher than in low-income areas (RR=1.33), with substantial variation between public housing developments (RR=1.81), particularly for chronic obstructive pulmonary disease (RR=3.38).
Conclusions:
- Preventable hospitalization rates are elevated among New York City public housing residents and exhibit considerable variation by development and condition.
- Geocoded hospital discharge data offer valuable insights for health assessment and stakeholder engagement.
- Targeted interventions are needed to address health inequities and reduce preventable hospitalizations in vulnerable populations.
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