School-based Stock Inhaler Programs and Neighborhood Disadvantage.

Area of Science:

• Public Health
• Pediatric Asthma Management
• Health Disparities

Background:

• Access to rescue medication, such as albuterol, is crucial for students with asthma, particularly those in underserved areas.
• Neighborhood deprivation can significantly impact healthcare access and utilization for student populations.

Purpose of the Study:

• To investigate the relationship between neighborhood deprivation, measured by the Area Deprivation Index (ADI), and the use of stock albuterol inhalers in schools.
• To identify potential disparities in asthma medication access among students in varying levels of community deprivation.

Main Methods:

• Utilized data from the Pima County (Arizona) Stock Inhaler Program, including 228 participating schools.
• Categorized schools into quartiles based on census block ADI to assess neighborhood deprivation.
• Employed hurdle regression to analyze associations between ADI quartiles and stock inhaler use, controlling for school characteristics.

Main Results:

• Schools in the second worst ADI quartile demonstrated higher odds of stock inhaler use compared to the most deprived quartile (OR 1.9, 95% CI 1.2-2.9).
• Middle schools exhibited significantly higher odds of stock inhaler use than elementary schools (OR 2.1, 95% CI 1.3-3.4).

Conclusions:

• Students in schools within the second most deprived communities, relative to the most deprived, may face the most precarious access to albuterol.
• Findings highlight the need for targeted interventions to ensure equitable asthma medication access in schools located in disadvantaged neighborhoods.