Spatial analysis of potentially preventable pneumonia and asthma hospitalizations for children in the Texas Coastal Bend area

Pneumonia and asthma, two common Ambulatory Care Sensitive Conditions (ACSCs), were two top reasons for the admission of children to the hospitals and emergency rooms in the United States in 2011. Pneumonia and asthma are potentially preventable if the child’s environment is properly managed. Underlying vulnerabilities such as low socioeconomic status (SES) and proximity to air pollution play an important role in ACSCs hospitalization. Pneumonia and asthma are two common reasons for hospitalizations among children and missed school days in Texas Coastal Bend Area. This thesis examines the relationships between neighborhood socioeconomic characteristics, meteorological conditions and children ACSCs hospitalization, including pneumonia and asthma among children age 0-17 in this area. Hospital discharge data from 2007 to 2009 based on Zip Code Tabulation Area (ZCTA) were examined along with American Community Survey (ACS) data, air pollution data from Environmental Protection Agency (EPA) and temperature data from National Climatic Data Center (NCDC). Hotspot and Local Moran’s I analyses were applied to identify the concentrations of the illnesses. Two regressions (OLS and GWR) were applied to identify factors that contribute the most to ACSCs hospitalization. Pearson’s correlation was calculated to examine the relationship between meteorological condition and child hospitalization for asthma and pneumonia. A human subject survey was conducted to examine the relationships between neighborhood environment and children asthma cases. The main finding was that children from families with health insurance, children from single father families and children from poor families were more likely to visit hospital for ACSCs and pneumonia care. “Hispanic families” and especially “Hispanic families with father but no mother” also contributed most to child hospitalization for ACSCs and pneumonia, suggesting that family preventative health care education is needed for Hispanic families and particularly Hispanic fathers. Air pollution and temperature analysis revealed that high concentrations of Ozone and Sulfur Dioxide likely cause pneumonia and asthma hospitalization of children. Combined with dramatic change in temperature, air pollution played an important role in the hospitalization of pneumonia and asthma plagued children in the coastal bend area. The human subject survey showed that the time children spent outdoors was highly positive correlated with asthma rate.