Cumulative Impact of Environmental Pollution and Population Vulnerability on Pediatric Asthma Hospitalizations: A Multilevel Analysis of CalEnviroScreen

Emanuel Alcala, Paul Brown, John A. Capitman, Mariaelena Gonzalez and Ricardo Cisneros
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Emanuel Alcala: Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA
Paul Brown: Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA
John A. Capitman: Central Valley Health Policy Institute, College of Health and Human Services, California State University, Fresno, CA 93740, USA
Mariaelena Gonzalez: Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA
Ricardo Cisneros: Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA

IJERPH, 2019, vol. 16, issue 15, 1-12

Abstract: The CalEnviroScreen created by the Office of Environmental Health Hazard Assessment, Sacramento, USA, is a place-based dataset developed to measure environmental and social indicators that are theorized to have cumulative health impacts on populations. The objective of this study was to examine the extent to which the composite scores of the CalEnviroScreen tool are associated with pediatric asthma hospitalization. This was a retrospective analysis of California hospital discharge data from 2010 to 2012. Children who were hospitalized for asthma-related conditions, were aged 0–14 years, and resided in California were included in analysis. Rates of hospitalization for asthma-related conditions among children residing in California were calculated. Poisson multilevel modeling was used to account for individual- and neighborhood-level risk factors. Every unit increase in the CalEnviroScreen Score was associated with an increase of 1.6% above the mean rate of pediatric asthma hospitalizations (rate ratio (RR) = 1.016, 95% confidence interval (CI) = 1.014–1.018). Every unit increase in racial/ethnic segregation and diesel particulate matter was associated with an increase of 1.1% and 0.2% above the mean rate of pediatric asthma, respectively (RR = 1.011, 95% CI = 1.010–1.013; RR = 1.002, 95% CI = 1.001–1.004). The CalEnviroScreen is a unique tool that combines socioecological factors and environmental indicators to identify vulnerable communities with major health disparities, including pediatric asthma hospital use. Future research should identify mediating factors that contribute to community-level health disparities.

Keywords: screening tool; environmental justice; air pollution; pediatric asthma; multilevel analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (6)

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