Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery

Butler, Danielle; Petterson, Stephen; Phillips, Robert L.; Bazemore, Andrew

doi:10.1111/j.1475-6773.2012.01449.x

Cited by 365 publications

(337 citation statements)

References 24 publications

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“…5,[26][27][28][29][30][31][32] Additionally, it is unclear whether socioeconomic and racial variability in food allergy is intrinsic to the disease verification process; however, many have speculated that it is attributable, in least at part, to barriers to care among racial/ ethnic minorities and disadvantaged households. [33][34][35][36][37] Additionally, this study determined that students attending school on the city' s North-Northwest Side were significantly more likely to have a school health management plan on file than students from any other region of Chicago. These findings speak to the general racial/ ethnic and socioeconomic segregation of the city, as well as limitations in access to care, which likely impact documentation of chronic disease and access to school health management plans in CPS.…”

Section: Discussionmentioning

confidence: 97%

Asthma and Food Allergy Management in Chicago Public Schools

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Asthma and food allergy are common chronic conditions impacting 14% and 8% of US schoolaged children, respectively. School districts must be prepared to track students who have these conditions to ensure proper daily management and emergency response. WHAT THIS STUDY ADDS:This study examines the demographic distribution of asthma and food allergy and the existence of school health management plans in a large, urban school district. The findings show that school health management plans are underused for both conditions. abstract OBJECTIVES: This study aimed to characterize asthma and food allergy reporting and management in Chicago Public Schools.METHODS: Demographic and health data for students who have asthma and food allergy were extracted from the Chicago Public Schools database. Demographic and geographic variability and the existence of school health management plans were analyzed, and multiple logistic regression models were computed. Home addresses were geocoded to create maps of case counts per community area. RESULTS:Approximately 18 000 asthmatic and 4000 food allergic students were identified. Of asthmatic students, 9.3% had a food allergy; of food allergic students, 40.1% had asthma. Asthma odds were significantly higher among black and Hispanic students (odds ratio [OR] = 2.3 and 1.3, respectively), whereas food allergy odds were significantly higher among black students (OR = 1.1; 95% confidence interval [CI], 1.0-1.3) and significantly lower among Hispanic students (OR = 0.8; 95% CI, 0.7-0.9). Only 24.3% of students who had asthma and 50.9% of students who had food allergy had a school health management plan on file. Odds of having a school health management plan were significantly higher among students with both conditions, but the likelihood of having a plan on file was significantly lower among racial/ethnic minority and low-income students, regardless of medical condition.CONCLUSIONS: Only 1 in 4 students who have asthma and half of food allergic students have health management plans in schools, with lower numbers among minority and low-income students. Improving chronic disease reporting and access to school health management plans is critical. Pediatrics 2014;134:729-736

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Section: Discussionmentioning

confidence: 97%

Asthma and Food Allergy Management in Chicago Public Schools

et al. 2014

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“…Assim sendo, alguns autores têm utilizado o espaço como uma categoria de análise no estudo das iniquidades em saúde 10,11,12 .…”

Section: Introductionunclassified

Desigualdades sociais na distribuição espacial das hospitalizações por doenças respiratórias

et al. 2013

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Para verificar as desigualdades sociais nas hospitalizações por doenças do aparelho respiratório em Salvador, Bahia, Brasil, 2001-2007, realizou-se estudo ecológico espacial, tendo como unidade de análise zonas de informação. Estas foram estratificadas considerando um indicador de condições de vida e analisadas por regressão de Poisson. A distribuição espacial das taxas de hospitalização por doenças do aparelho respiratório variou de 3,3 a 80,5/10 mil habitantes. Asma, pneumonia e doença pulmonar obstrutiva crônica (DPOC) apresentaram padrão espacial heterogêneo, no qual estratos de piores condições de vida apresentaram maior risco de ocorrência dessas internações. A taxa de hospitalização por doenças do aparelho respiratório foi 2,4 vezes maior no estrato de condições de vida muito baixas do que no primeiro estrato. Houve redução das desigualdades para pneumonia e aumento para asma e DPOC. A existência de forte gradiente social reforça a hipótese de que aspectos socioeconômicos são determinantes das hospitalizações por doenças do aparelho respiratório.

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“…Community VSs, such as poverty level, education attained, or employment status, could be independent social determinants of health, or they could be indices of these factors. [1][2][3][4] Either way, community VSs convey contextual social deprivation and associated risks based on where patients live, and this is important information that could influence point-of-care decisions, similar to physiologic vital signs. We suggest that currently available information technologies using population-level data allow us to integrate these social elements into clinically useful community VSs without burdening providers.…”

mentioning

confidence: 99%

Community Vital Signs: Taking the Pulse of the Community While Caring for Patients

Hughes

Phillips

DeVoe

et al. 2016

The Journal of the American Board of Family Medicine

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In 2014 both the Institute of Medicine and the National Quality Forum recommended the inclusion of social determinants of health data in electronic health records (EHRs). Both entities primarily focus on collecting socioeconomic and health behavior data directly from individual patients. The burden of reliably, accurately, and consistently collecting such information is substantial, and it may take several years before a primary care team has actionable data available in its EHR. A more reliable and less burdensome approach to integrating clinical and social determinant data exists and is technologically feasible now. Community vital signs-aggregated community-level information about the neighborhoods in which our patients live, learn, work, and play-convey contextual social deprivation and associated chronic disease risks based on where patients live. Given widespread access to "big data" and geospatial technologies, community vital signs can be created by linking aggregated population health data with patient addresses in EHRs. These linked data, once imported into EHRs, are a readily available resource to help primary care practices understand the context in which their patients reside and achieve important health goals at the patient, population, and policy levels.

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Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery

Abstract: This geographic index has utility for identifying areas in need of assistance and is timely for revision of 35-year-old provider shortage and geographic underservice designation criteria used to allocate federal resources.

Cited by 365 publications

References 24 publications

Asthma and Food Allergy Management in Chicago Public Schools

Asthma and Food Allergy Management in Chicago Public Schools

Desigualdades sociais na distribuição espacial das hospitalizações por doenças respiratórias

Community Vital Signs: Taking the Pulse of the Community While Caring for Patients

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