Abstract：
Attributes defining the Social Determinants of Health (SDoH) are associated with disproportionate exposures to environmental hazards and differential health outcomes among communities. The dynamics between SDoH, disproportionate environmental exposures, and differential health outcomes are often specific to micro-geographic areas.
This study focused on children less than 20 years of age who lived in Douglas County, Nebraska, during 2016-2019. To assess the role of SDoH in differential exposures, we evaluated the association between SDoH metrics and criteria pollutant concentrations and the association between SDoH and pediatric asthma exacerbations to quantify the role of SDoH in differential pediatric asthma outcomes. The Bayesian Poisson regression model with spatial random effects was used to evaluate associations.
We identified significant positive associations between the annual mean concentration of criteria pollutants (carbon monoxide, particulate matter2.5, nitrogen dioxide, sulfur dioxide) with race (Non-Hispanic Black and Hispanic/Latino), financial stability, and literacy. Additionally, there were significant positive associations between higher rates of pediatric asthma emergency department visits and neighborhoods with more Non-Hispanic Black children, children without health insurance coverage, and households without access to a vehicle.
Non-Hispanic Black and Hispanic/Latino children living in Douglas County, NE experience disproportionately higher exposure to criteria pollutant concentrations. Additionally, higher rates of asthma exacerbations among Non-Hispanic Black children could be due to reduced access to respiratory care that is potentially the result of financial instability and vehicle access. These results could inform city planners and health care providers to mitigate respiratory risks among these higher at-risk populations.
This study focused on children less than 20 years of age who lived in Douglas County, Nebraska, during 2016-2019. To assess the role of SDoH in differential exposures, we evaluated the association between SDoH metrics and criteria pollutant concentrations and the association between SDoH and pediatric asthma exacerbations to quantify the role of SDoH in differential pediatric asthma outcomes. The Bayesian Poisson regression model with spatial random effects was used to evaluate associations.
We identified significant positive associations between the annual mean concentration of criteria pollutants (carbon monoxide, particulate matter2.5, nitrogen dioxide, sulfur dioxide) with race (Non-Hispanic Black and Hispanic/Latino), financial stability, and literacy. Additionally, there were significant positive associations between higher rates of pediatric asthma emergency department visits and neighborhoods with more Non-Hispanic Black children, children without health insurance coverage, and households without access to a vehicle.
Non-Hispanic Black and Hispanic/Latino children living in Douglas County, NE experience disproportionately higher exposure to criteria pollutant concentrations. Additionally, higher rates of asthma exacerbations among Non-Hispanic Black children could be due to reduced access to respiratory care that is potentially the result of financial instability and vehicle access. These results could inform city planners and health care providers to mitigate respiratory risks among these higher at-risk populations.
摘要：
背景：定义健康的社会决定因素（SDoH）的属性与社区中不成比例的环境危害暴露和不同的健康结果有关。SDoH之间的动态，不成比例的环境暴露，和不同的健康结果通常特定于微观地理区域。
方法：这项研究的重点是居住在道格拉斯县的20岁以下的儿童，内布拉斯加州,2016-2019年。为了评估SDoH在差异暴露中的作用，我们评估了SDoH指标与标准污染物浓度之间的关联,以及SDoH与小儿哮喘加重之间的关联,以量化SDoH在小儿哮喘结局差异中的作用.使用具有空间随机效应的贝叶斯泊松回归模型来评估关联。
结果：我们发现标准污染物的年平均浓度（一氧化碳，颗粒物2.5，二氧化氮，二氧化硫）与种族（非西班牙裔黑人和西班牙裔/拉丁美洲人），金融稳定,和识字。此外,儿科哮喘急诊就诊率较高与非西班牙裔黑人儿童较多的社区之间存在显著正相关，没有医疗保险的儿童，和无法使用车辆的家庭。
结论：居住在道格拉斯县的非西班牙裔黑人和西班牙裔/拉丁裔儿童，NE经历不成比例的更高暴露于标准污染物浓度。此外,非西班牙裔黑人儿童哮喘加重率较高,可能是由于获得呼吸护理的机会减少,这可能是金融不稳定和车辆使用的结果.这些结果可以告知城市规划者和医疗保健提供者，以减轻这些高危人群的呼吸风险。
方法：这项研究的重点是居住在道格拉斯县的20岁以下的儿童，内布拉斯加州,2016-2019年。为了评估SDoH在差异暴露中的作用，我们评估了SDoH指标与标准污染物浓度之间的关联,以及SDoH与小儿哮喘加重之间的关联,以量化SDoH在小儿哮喘结局差异中的作用.使用具有空间随机效应的贝叶斯泊松回归模型来评估关联。
结果：我们发现标准污染物的年平均浓度（一氧化碳，颗粒物2.5，二氧化氮，二氧化硫）与种族（非西班牙裔黑人和西班牙裔/拉丁美洲人），金融稳定,和识字。此外,儿科哮喘急诊就诊率较高与非西班牙裔黑人儿童较多的社区之间存在显著正相关，没有医疗保险的儿童，和无法使用车辆的家庭。
结论：居住在道格拉斯县的非西班牙裔黑人和西班牙裔/拉丁裔儿童，NE经历不成比例的更高暴露于标准污染物浓度。此外,非西班牙裔黑人儿童哮喘加重率较高,可能是由于获得呼吸护理的机会减少,这可能是金融不稳定和车辆使用的结果.这些结果可以告知城市规划者和医疗保健提供者，以减轻这些高危人群的呼吸风险。
