Socioeconomic and environmental determinants of asthma prevalence: a cross-sectional study at the U.S. County level using geographically weighted random forests

Abstract

Background Some studies have established associations between the prevalence of new-onset asthma and asthma exacerbation and socioeconomic and environmental determinants. However, research remains limited concerning the shape of these associations, the importance of the risk factors, and how these factors vary geographically. Objective We aimed (1) to examine ecological associations between asthma prevalence and multiple socio-physical determinants in the United States; and (2) to assess geographic variations in their relative importance. Methods Our study design is cross sectional based on county-level data for 2020 across the United States. We obtained self-reported asthma prevalence data of adults aged 18 years or older for each county. We applied conventional and geographically weighted random forest (GWRF) to investigate the associations between asthma prevalence and socioeconomic (e.g., poverty) and environmental determinants (e.g., air pollution and green space). To enhance the interpretability of the GWRF, we (1) assessed the shape of the associations through partial dependence plots, (2) ranked the determinants according to their global importance scores, and (3) mapped the local variable importance spatially. Results Of the 3059 counties, the average asthma prevalence was 9.9 (standard deviation ± 0.99). The GWRF outperformed the conventional random forest. We found an indication, for example, that temperature was inversely associated with asthma prevalence, while poverty showed positive associations. The partial dependence plots showed that these associations had a non-linear shape. Ranking the socio-physical environmental factors concerning their global importance showed that smoking prevalence and depression prevalence were most relevant, while green space and limited language were of minor relevance. The local variable importance measures showed striking geographical differences. Conclusion Our findings strengthen the evidence that socio-physical environments play a role in explaining asthma prevalence, but their relevance seems to vary geographically. The results are vital for implementing future asthma prevention programs that should be tailor-made for specific areas.

The Role of Biodiversity in the Development of Asthma and Allergic Sensitization: A State-of-the-Science Review

“…It should also be noted that other factors can play a role in variability and/or inconsistence of the results. For instance, the geographic distribution of the included studies, and inclusion of individuals from different populations, may contribute to the variability in results due to exposure to different environments and social and behavioral risk factors (e.g., medications, 91 dietary habits, 92 , 93 exposure to natural/built-up areas, 8 , 36 , 75 , 94 socioeconomic status 95 ). 89 , 96 In addition, the results suggest that further efforts are needed for causal inference and elaboration of the exact underlying mechanisms by which biodiversity exposure influences the development of asthma and allergic diseases.…”

Impacts of socioeconomic and environmental factors on neoplasms incidence rates using machine learning and GIS: a cross-sectional study in Iran

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Enhancing Airborne Disease Prediction: Integrating Deep Infomax and Self-Organizing Maps for Risk Factor Identification

“…In a research report published by Shally Awasthi, Priya Tripathi, and Rajendra Prasad, [10] the authors aimed to identify asthma risk factors, including environmental exposures like motor vehicle air pollution, industrial smoke, active and passive smoking, and exposure to environmental tobacco smoke (ETS). The analysis, conducted according to Global Initiative for Asthma guidelines, categorized participants into two age groups, revealing significant associations between the studied environmental factors and asthma.…”