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Patterns and drivers of disparities in pediatric asthma outcomes among Medicaid-enrolled children living in subsidized housing in NYC.
- Source :
-
Preventive medicine [Prev Med] 2024 Aug; Vol. 185, pp. 108023. Date of Electronic Publication: 2024 Jun 20. - Publication Year :
- 2024
-
Abstract
- Objective: There are persistent disparities in pediatric asthma morbidity in the U.S. We linked claims data with information on neighborhood-level risk factors to explore drivers of asthma disparities among Medicaid-enrolled children in New York City subsidized housing.<br />Methods: We constructed a cohort of Medicaid-enrolled children living in public or other subsidized housing, based on residential address, in NYC between 2016 and 2019 (n = 108,969). We examined claims-derived asthma prevalence across age and racial and ethnic groups, integrating census tract-level information and using the Bayesian Improved Surname Geocoding (BISG) algorithm to address high rates of missing data in self-reported race and ethnicity. We used inverse probability weighting (IPW) to explore the extent to which disparities persisted when exposure to asthma risk factors - related to the built environment, neighborhood poverty, and air quality - were balanced across groups. This analysis was conducted in 2022-2023.<br />Results: Claims-derived asthma prevalence was highest among children <7 years at baseline and among non-Hispanic Black and Hispanic children. For example, among children aged 3-6 years at baseline, claims-derived prevalence was 17.3% and 18.1% among non-Hispanic Black and Hispanic children, respectively, compared to 9.3% and 9.0% among non-Hispanic White and non-Hispanic Asian American/Pacific Islander children. Using IPW to balance exposure to asthma risk factors across racial and ethnic groups attenuated, but did not eliminate, disparities in asthma prevalence.<br />Conclusions: We found high asthma burden among children living in subsidized housing. Modifiable place-based characteristics may be important contributors to pediatric asthma disparities.<br />Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare.<br /> (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Child, Preschool
Female
Humans
Infant
Male
Ethnicity statistics & numerical data
Health Status Disparities
Neighborhood Characteristics
New York City epidemiology
Prevalence
Public Housing statistics & numerical data
Residence Characteristics statistics & numerical data
Risk Factors
United States epidemiology
Racial Groups
Asthma ethnology
Asthma epidemiology
Medicaid statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1096-0260
- Volume :
- 185
- Database :
- MEDLINE
- Journal :
- Preventive medicine
- Publication Type :
- Academic Journal
- Accession number :
- 38908569
- Full Text :
- https://doi.org/10.1016/j.ypmed.2024.108023