Dashboard identifies social determinants of health among children with asthma
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October 07, 2022
2 min read
Source/Disclosures
Carstairs K, et al. Creating a system to identify social determinants of health and achieve equitable health outcomes for children with asthma. Presented at: AAP National Conference & Exhibition, Oct. 7-10, 2022; Anaheim, Calif.
Disclosures:
Healio could not confirm relevant financial disclosures at the time of publication.
A dashboard revealed disparities that exist among patients with moderate to severe asthma who visited the ED, according to a study scheduled for presentation at the American Academy of Pediatrics National Conference & Exhibition.
“When managing the health of a child and, in particular, any chronic condition such as asthma, it is critical to acknowledge the profound importance that social determinants, race, ethnicity and language barriers play in the life of that child and family,” Keri L. Carstairs, MD, vice president of network operations and clinical integration at Rady Children’s Hospital-San Diego, said in an American Academy of Pediatrics press release.
Keri L. Carstairs
Rady Children’s received a grant to develop the Asthma Health Equity Index, a dashboard designed to redefine how researchers capture and display equity-related data to address a need for a standardized approach to measure and track improvements related to health equity.
The dashboard provides valuable insights into location, race and ethnicity, language, payor type, household income, prior ED visits, social determinants of health (SDOH) and school information, as well as real-time information for targeting specific equity gaps and developing interventions.
A patient care coordinator conducted telephone outreach with the families of children with poorly controlled asthma who had recently visited the ED to identify disparities based on SDOH screenings for food insecurity, housing, transportation and tobacco use while ensuring that these families had adequate follow-up and asthma education. Patients primarily were Hispanic (56.1%) or non-Hispanic Black or other (23.2%).
The researchers observed strong associations between race and ethnicity and food insecurity, unstable housing and tobacco use (all, P < .001). For example, patients who identified as Hispanic, non-Hispanic Black and non-Hispanic other were three to five times more likely than non-Hispanic white patients to experience unstable housing (P < .001).
The researchers additionally found that Hispanic families were three times more likely to experience food insecurity and transportation issues (both, P < .001) than non-Hispanic white families, and non-Hispanic Black families were twice as likely to experience tobacco use and smoke exposure (P < .001).
Also, there were strong associations between language and food insecurity (P < .001), unstable housing (P < .001) and transportation issues (P = .05). Specifically, patients who spoke Spanish were 4.6 times more likely to experience food insecurity (P < .001) and twice as likely to experience unstable housing (P < .001) and transportation issues (P = .03).
Overall, the researchers said that children living with asthma who were Hispanic and from Spanish-speaking families were at higher risk for SDOH.
Believing that these disparities present preventable harm, the researchers said that identifying gaps and interventions can help them determine which systemic processes and structures promote disparities.
“By committing to an understanding of those needs that extend beyond the health care setting, we can have a greater impact on the health of children by designing necessary interventions to support these needs through the development of a collaborative community ecosystem with community partnerships that can support vulnerable populations,” Carstairs said.
Reference:
American Academy of Pediatrics National Conference and Exhibition
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