Recorded presentation

Henry J. Carretta, ABD MPH¹, Elizabeth L. McGarvey, EdD², and Adrienne Keller, PhD². (1) Department of Health Administration, Virginia Commonwealth University, 1008 E Clay Street, Grant House Room 212, Richmond, VA 23298, 804-828-0172, hjcarret@hsc.vcu.edu, (2) Division of Prevention Research, Dept. of Psychiatric Medicine, University of Virginia, P.O. Box 800623, Charlotesville, VA 22908

Asthma morbidity and mortality is known to be related to a variety of factors including patient characteristics, health system factors, and exposure to known triggers. Asthma control is improved by interventions that address macro problems such as environmental triggers and health system characteristics plus micro problems such as physician practice and patient self- efficacy. Asthma hospitalizations are preventable and therefore represent a marker of failure to address the population or individual determinants of the disease. This study examined the relationship between macro determinants of asthma hospitalizations such as population characteristics, health system resources, and outdoor air quality and asthma hospitalizations.

Negative binomial regression was used to examine the relationship between the number of annual hospital admissions with a primary diagnosis of asthma with the size of the Black and poor populations (which have higher rates of hospitalization), the availability of hospital beds and patient care physicians and the Environmental Protection Agency’s (EPA) Air Quality Index (AQI) for 38 Virginia counties and cities in 2001. Data was mapped using geographic information system software.

The number of annual days with EPA designation of “unhealthy for sensitive groups” or “unhealthy” was significantly (p<.001) related to the number of hospitalizations in these Virginia counties after controlling for patient and health system characteristics.

Asthma is a multifaceted problem requiring stakeholders to design interventions and services directed at macro and micro determinants of asthma morbidity. The use of mapping software graphically display these clustered relationship may prove useful in designing strategically targeted intervention.

Learning Objectives:

• List sources for outdoor air quality, physician and hospital resource data
• Evaluate the usefulness of maps prepared with a geographic information system for examining spatial relationships
• Describe the macro and micro determinants of asthma morbidity and mortality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation