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The Burden and Social Determinants of Asthma Among Children in the State of Georgia
Mark H Ebell1, Christian Marchello2, Lu Meng3
1Department of Epidemiology, College of Public Health, University of Georgia, 125 Miller Hall UGA Health Sciences Campus, Athens, GA, 30602, USA. ebell@uga.edu.
Insights
African-American children face a higher prevalence of asthma and disproportionately higher rates of hospitalizations and emergency department visits. Addressing social determinants is crucial for improving pediatric asthma outcomes.
Area of Science:
- Pediatric Health
- Public Health
- Epidemiology
Background:
- Asthma is a prevalent chronic condition in children.
- Social determinants significantly influence pediatric asthma risk and outcomes.
- Understanding disparities in asthma care is critical for public health initiatives.
Purpose of the Study:
- To investigate the association between social determinants and asthma-related outcomes in children in Georgia.
- To identify key risk factors and predictors of asthma in a pediatric population.
- To analyze disparities in asthma prevalence and healthcare utilization among different racial and ethnic groups.
Main Methods:
- Utilized Georgia data from the Behavioral Risk Factor Surveillance System (BRFSS) and hospital/emergency department surveys (2011-2016).
- Employed SAS and SUDAAN for weighted prevalence estimates and univariate/multivariate analyses.
- Examined associations between social determinants, demographics, and asthma outcomes.
Main Results:
- Asthma prevalence is higher in African-American children and those from households with annual incomes under $75,000.
- African-American race was the strongest independent predictor of asthma (aOR 2.9, 95% CI 1.5-5.8).
- African-American and multiracial children experienced 2-5 times higher rates of asthma-related hospitalizations and ED visits, despite declining secular trends.
Conclusions:
- African-American race is a significant independent predictor of childhood asthma in Georgia.
- Substantial disparities exist in asthma burden, with African-American and multiracial children facing disproportionately higher rates of severe outcomes.
- Targeted programmatic efforts are essential to improve asthma care access, adherence, and knowledge for vulnerable pediatric populations.
Abstract:
Asthma is one of the most common chronic health conditions in children, and social determinants are thought to be important risk factors. We used Georgia data from the Behavioral Risk Factors Surveillance Survey (BRFSS), and data from the Georgia hospital and emergency department survey for children with a diagnosis of asthma. All data were from the years 2011 to 2016. SAS and SUDAAN were used to calculate weighted prevalence estimates and to perform univariate and multivariate analysis of the association between social determinants, demographic characteristics, other potential risk factors, and asthma-related outcomes. The prevalence of asthma is higher in African-American children and when the parental income is less than $75,000 per year. A multivariate analysis adjusting for ethnicity, parental income, and sex found that the strongest independent predictor of asthma was African-American race (aOR 2.9, 95% CI 1.5-5.8). African-American and multiracial children also experienced extremely high burdens due to asthma related hospitalizations and emergency department visits, with rates two to five times higher than children in other groups. The secular trend for ED visits and hospitalizations is declining. African-American race is an independent predictor of asthma in children in Georgia, and African-American and multiracial children experience a greater burden of asthma than children of other races. Programmatic efforts at the state and national level to improve access, adherence, and knowledge about asthma are important if we are to continue to improve outcomes for these children.
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