Neighborhoods with improved socioeconomic and educational opportunities are more likely to have lower rates of asthma-related emergency department (ED) visits among children younger than 5 years old in Washington, DC, according to a study published in The Journal of Allergy and Clinical Immunology.

In this cross-sectional study, researchers examined 3,806 children who were under the age of 5 with physician-diagnosed asthma, who were included in the Washington, DC, Pediatric Asthma Registry between January 2018 and December 2019. Children in this age group experience disproportionately high rates of asthma. Researchers sought to evaluate census tract associations between the Child Opportunity Index (COI) and at-risk rates for pediatric asthma-related ED encounters and hospitalizations.

Of the 3,806 children, 2,132 (56%) kids had a collective 5,852 ED encounters, and 821 (22%) kids had a collective 1,418 hospitalizations. Greater census tract overall COI, social/economic COI, and educational COI were associated with fewer ED at-risk rates. There were no associations between the health/environmental COI and ED at-risk rates or between the COI and hospitalization at-risk rates.

Researchers determined that improving community-level social, economic, and educational opportunity within specific census tracts may reduce ED at-risk rates in this population.

“The Child Opportunity Index incorporates 29 different measures of social determinants of health into one single measure. Our findings highlight that higher overall opportunity scores of a child’s neighborhood are associated with lower rates of emergency room visits for asthma-related illness,” says Jordan Tyris, MD, a hospitalist and lead author of the study, in a release. “In particular, the socioeconomic and educational measures drove this association. This tells us that improving socioeconomic and educational factors in areas with higher asthma-related ED utilization might help reduce how often children are getting sick from their asthma.”

According to Tyris, these findings highlight the importance of considering efforts to improve social, educational, and economic-related characteristics of communities as another method to reduce asthma morbidity in early childhood.

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