A census tract-level assessment of social determinants of health,traffic exposure,and asthma exacerbations in New York State's Medicaid Population(2005–2015)  

作　　者：Temilayo Adeyeye Tabassum Zarina Insaf Catherine Adler Victoria Wagner Anisa Proj Susan McCauley 

机构地区：[1]Bureau of Environmental and Occupational Epidemiology,New York State Department of Health,Albany,NY 12237,USA [2]Department of Environmental Health Sciences,University at Albany School of Public Health,Albany,NY 12222,USA [3]Bureau of Cancer Epidemiology,New York State Department of Health,Albany,NY 12237,USA [4]Department of Epidemiology and Biostatistics,University at Albany School of Public Health,Albany,NY 12222,USA [5]Office of Quality and Patient Safety,New York State Department of Health,Albany,NY 12237,USA [6]Bureau of Chronic Disease Evaluation and Research,New York State Department of Health,Albany,NY 12237,USA

出　　处：《Eco-Environment & Health》2024年第3期300-307,共8页生态环境与健康（英文）

基　　金：supported by the CDC's Modernizing Environmental Public Health Tracking to Advance Environmental Health Surveillance Program,NYS Unique Federal Award Number NUE1EH001482.

摘　　要：This study aims to evaluate the association between social determinants,environmental exposure metrics,and the risk of asthma emergency department(ED)visits in the New York State(NYS)Medicaid population using smallarea analysis.Traffic densities for each census tract in NYS were calculated using the length of road segments within each tract and total area of the tract to produce a measure of average number of vehicles per square meter per day.Data on social determinants of health including internal and external environments and other demographic factors were obtained from various sources.Poisson regression analyses were conducted to identify significant factors associated with asthma ED visits in Medicaid claim and encounter data for years 2005–2015.High traffic density in NYS excluding New York City(NYC)correlated with increased risk of asthma ED visits(RR 1.69;95%CI:1.42,2.00),mitigated by adjusting for environmental and social determinants(RR 1.00;95%CI:0.85,1.19).Similar trends were observed in NYC only(RR 1.19;95%CI:1.00,1.41),with the adjusted risk remaining elevated(RR 1.14;95%CI:0.98,1.33)albeit not statistically significant.Living in census tracts with high concentrated disadvantage index,high proportions of minorities,and less green space predicted higher asthma ED visits.We mapped predicted rates and model residuals to identify areas of high risk.Our results support previous findings that environmental and social risk factors in poor and urban areas contribute to asthma exacerbations in the NYS Medicaid population,even if they may not necessarily contribute to its development.

关 键 词：ASTHMA MEDICAID Social determinants Traffic density Environmental exposures 

分 类 号：R51[医药卫生—内科学] R56[医药卫生—临床医学]