The relationship between neighborhood economic deprivation and asthma-associated emergency department visits in Maryland.

Background: Asthma represents a substantial public health challenge in the United States, affecting over 25 million adults. This study investigates the impact of neighborhood economic deprivation on asthma-associated Emergency Department (ED) visits in Maryland, using the Distressed Communities Index (DCI) for analysis. Methods: A retrospective analysis of Maryland's Emergency Department Databases from January 2018 to December 2020 was conducted, focusing on asthma-associated ED visits. Results: The study involved 185,317 ED visits, majority of which were females (56.3%) and non-Hispanic whites (65.2%). A significant association was found between increased neighborhood socioeconomic deprivation and asthma-related ED visits. The poorest neighborhoods showed the highest rates of such visits. Compared to prosperous areas, neighborhoods classified from Comfortable to Distressed had progressively higher odds for asthma-related ED visits (Comfortable: OR = 1.14, Distressed OR = 1.65). Other significant asthma predictors included obesity, female gender, tobacco smoking, and older age. Conclusion: There is a substantive association between higher asthma-related ED visits and high neighborhood economic deprivation, underscoring the impact of socioeconomic factors on health outcomes. Public health implications: Addressing healthcare disparities and improving access to care in economically distressed neighborhoods is crucial. Targeted interventions, such as community health clinics and asthma education programs, can help mitigate the impact of neighborhood disadvantage.

Exploring the Relationship Between Community-Level Economic Deprivation and HIV Infection Among Hospital Admissions in Washington, DC.

Introduction Human immunodeficiency virus (HIV) infection is a significant health concern in the United States, affecting 38 million Americans. Despite a recent decline in prevalence, social determinants of health remain an important factor driving infections, particularly among minority populations. However, the relationship between community-level economic deprivation indices and HIV infection among hospital admissions has been understudied in the literature. Objectives This study investigated the association between community-level economic deprivation, measured by the Distressed Community Index (DCI), and HIV infection among hospital admissions in Washington, District of Columbia (DC). Methods We utilized data from the State Inpatient Database (SID) for Washington, DC, between 2016 and 2019, identifying all admissions with a history of HIV. The multivariate analysis determined the association between DCI quintiles and HIV infection among hospital admissions. Also included in the multivariate analysis were patients' age, sex, race/ethnicity, insurance type, smoking status, obesity, sexually transmitted infections (STIs), hepatitis B infections, and mental health conditions. Results Of the 213,682 admissions captured in the DCI quintiles, 67.4% were Black, 17.2% were White, and 10.7% were Hispanic. The prevalence of HIV infection in the study population was 4.4%. There was a statistically significant association between the DCI quintiles and HIV infection among hospital admissions. The residents of the richest neighborhoods defined as prosperous quintile (also the reference group) had the lowest odds of HIV infections compared to the other quintiles (comfortable, odds ratio {OR}=1.94 and 95% confidence interval {CI}=1.38-2.74; mid-tier, OR=1.49 and 95% CI=1.04-2.14; at risk, OR=1.75 and 95% CI=1.22-2.49; and distressed, OR=1.97 and 95% CI=1.38-2.82). Other significant predictors of HIV infection were Black race (OR=1.82; 95% CI=1.41-2.33), age between 45 and 65 years (OR=1.55; 95% CI=1.32-1.80), male sex (OR=1.58; 95% CI=1.40-1.77), and depression (OR=1.21; 95% CI=1.03-1.43). Conclusion This study reveals a significant association between increased levels of economic distress and the prevalence of HIV among hospital admissions in Washington, DC. Our findings emphasize the importance of taking social determinants of health into account when addressing HIV prevention and management. Implementing targeted interventions and resources in economically distressed communities may be crucial for reducing HIV prevalence and improving health outcomes for affected populations.