These differences in susceptibility in the extremely low-income group may not be apparent in health studies that use Medicaid enrollment as a proxy for low SES.Īsthma exacerbations are considered measures of asthma control and quality of care. Our findings suggest that even within a primarily low-income study population, socioeconomic differences persist.
We observed significant persistent disparities in asthma morbidity related to traffic exposure and race/ethnicity in a low-income population. Black non-Hispanics (OR = 2.35 95% CI:1.70,3.24), Hispanics (OR = 2.13 95% CI:1.49,3.04) and those with race listed as “Other” (OR = 1.89 95% CI:1.13,3.16) in high traffic areas had higher risk of recurrent asthma ED visits as compared to White non-Hispanics in low traffic areas. The highest risk was found for those exposed to high traffic and being male (OR = 1.87 95% CI:1.46,2.39), receiving cash assistance (OR = 2.11 95% CI:1.65,2.72), receiving supplemental security income (OR = 2.21 95% CI:1.66,2.96) and being in the 18.44 age group (OR = 1.59 95% CI 1.48,1.70) was associated with the highest risk of recurrent asthma ED visit. Additionally, we evaluated effect measure modification for risk of recurrent asthma visits associated with traffic exposure by socio-demographic factors. In a multivariate model, Medicaid recipients living within 300-m of a high traffic density area were at a statistically significant risk of a recurrent asthma ED visit compared to those in a low traffic density area (OR = 1.31 95% CI:1.24,1.38). Bivariate and multivariate logistic regression analyses were conducted to identify factors predicting recurrent asthma ED visits. Traffic densities (weighted for truck traffic) were spatially linked based on home addresses. The primary outcome of interest was a recurrent asthma ED visit within 1-year of index visit. This study aims to assess the association between traffic density and recurrence of asthma ED visits in the primarily low income Medicaid population in New York State (NYS) between 20.
However, these associations are often confounded by socioeconomic status and health care access. Environmental exposures such as traffic may contribute to asthma morbidity including recurrent emergency department (ED) visits.
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