Socio-demographic and environmental characteristics of children under 18 years seen for asthma exacerbation in the UPMC Children's Hospital of Pittsburgh emergency department from June 1, 2017 - May 31, 2018

Introduction: Asthma is a serious, chronic disorder that causes concern for healthcare providers, public health organizations and families. The number of individuals in the US diagnosed with asthma increases annually and asthma is one of the most common chronic diseases affecting children. While asthma is considered a complex disease, previous studies have shown that race, sex, poverty level, air pollution and exposure to secondhand smoke are significant risk factors for asthma. Objective: The aim of this study was to investigate the relationship of both socio-demographic and environmental variables and asthma visits for acute asthma exacerbation within a large children’s hospital. Methods: Patient data from UPMC Children’s Hospital of Pittsburgh was obtained for June 1, 2017 through May 31, 2018 for children 0-17 years of age seen in the emergency department with a discharge diagnosis of asthma (J45/J98.01). Patients were aggregated to Allegheny County census tracts based on their home address. Spatial analysis included both the number of cases and rates of cases visits per 1,000 population under 18 years of age census tracts as well as by age group, race and asthma score at initial visit. Linear regression models were run to test for an association between average monthly ozone and PM2.5 levels and monthly asthma visits, and between census tract ED visit rates and poverty and smoking levels. Results: Our sample of children was predominately African American, between the ages of 0 and 9 years of age and male. The majority of children had one visit in the calendar year and 58% (about half) were scored in the mild asthma score range. Poverty as measured by census tract of residence was found to a statistically significant predictor of asthma visits (p