Can Neighborhood Social and Environmental Context Account for Race/Ethnic Disparities in Childhood Asthma? Using Geocoded Medical Records to Explore an Ecological Model of Asthma

Mackenzie Brewer, Rice University
Kristin Osiecki, Rice University

Race and ethnic disparities in child asthma persist and are unexplained by a multitude of individual and family-level factors. Existing work on child asthma which incorporates neighborhood structural and environmental conditions suffers from small sample sizes, especially of children clustered within the same neighborhood; and poor measures of environmental quality. We improve on existing work by utilizing children’s clinical records linked with innovative techniques to assign environmental data to the children’s Census tracts. Utilizing a clinical sample of 14,331 pediatric patients aged 2-17 who visited a University of Texas Health clinic in 2011-2012 in Houston, TX, including more than 118,000 outpatient and inpatient visits, we are able to identify children who have physician-diagnosed asthma and link them to their residential neighborhoods. We find robust associations between particulate matter (PM) concentrations and the likelihood a child has asthma, after accounting for neighborhood poverty and a limited set of individual covariates.