Background

The extent to which asthma-related emergency department (ED) visit incidence rates vary from neighborhood to neighborhood and the predictors of neighorbood-level asthma ED visit burden are not well understood.

Objective

Our aim was to describe the census tract–level spatial distribution of asthma-related ED visits in Central Texas and identify neighborhood-level characteristics that explain variability in neighborhood-level asthma ED visit rates.

Methods

Conditional autoregressive models were used to examine the spatial distribution of asthma-related ED visit incidence rates across Travis County, Texas, census tracts and to assess the contribution of census tract characteristics to their distribution.

Results

There were distinct patterns in ED visit incidence rates at the census tract scale that were largely unexplained by socioeconomic or selected built environment neighborhood characteristics. Racial and ethnic composition explained 33% of the variability of ED visit incidence rates across census tracts. Spatial patterns and the census tract predictors of ED visit incidence rates differed by racial and ethnic groups.

Conclusions

Variability in asthma ED visit incidence rates are apparent at smaller spatial scales than previously examined. Most of the variability in census tract–level asthma ED visit rates in Central Texas is not explained by racial and ethnic composition or other neighborhood features. Race/ethnicity-specific estimates of neighborhood ED visit rates may be useful for identifying high-burden neighborhoods for specific ethnic and racial groups that otherwise would go unrecognized.

中文翻译：

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德克萨斯州中部哮喘相关急诊就诊的社区水平差异

背景

哮喘相关急诊 (ED) 就诊发生率因社区而异，以及社区一级哮喘 ED 就诊负担的预测因素尚不清楚。

客观的

我们的目的是描述德克萨斯州中部与哮喘相关的急诊就诊的人口普查区水平空间分布，并确定解释社区一级哮喘急诊就诊率变异性的社区特征。

方法

使用条件自回归模型来检查德克萨斯州特拉维斯县人口普查区中哮喘相关急诊就诊发病率的空间分布，并评估人口普查区特征对其分布的贡献。

结果

在人口普查范围内，急诊就诊发生率存在明显的模式，这在很大程度上无法用社会经济或选定的建筑环境社区特征来解释。种族和民族构成解释了各人口普查区急诊就诊发生率差异的 33%。急诊就诊发病率的空间模式和人口普查区预测因素因种族和民族群体而异。

结论

哮喘急诊就诊发病率的变异在比之前检查的更小的空间尺度上是明显的。德克萨斯州中部人口普查区一级哮喘急诊就诊率的大部分变异性不能用种族和民族构成或其他社区特征来解释。对社区急诊就诊率进行特定种族/民族的估计可能有助于确定特定民族和种族群体的高负担社区，否则这些社区将被忽视。