Social Determinants of Pneumonia Amongst Children
In the United States, respiratory issues are the most common reason for hospitalization of children. The prevalence of various respiratory issues is affected by many factors, such as geographical location and socioeconomic status, both considered social determinants of health. Social determinants of health are factors that influence the environments people live, work, and play in. They encompass a broad range of categories, including but not limited to: economic stability, access to education, access and quality of healthcare, social community, and neighborhood or built environment (the human-made or manufactured area one interacts with).
A recent research article, published by the Society for Experimental Biology and Medicine, examined how some of these social determinants of health affect rates of pneumonia. The researchers specifically studied how air quality, race/ethnicity, and insurance type influenced the rates of community-acquired pneumonia (CAP) amongst children in the Memphis Metropolitan Area (MMA). They measured the air quality based on the amount of particulate matter found in the air, specifically small matter from the combustion of diesel and gas and the burning of biomass and coal. Insurance type was used as an indicator of sorts for socioeconomic status: private and public insurance were the two types compared, with private insurance correlated with higher socioeconomic status than public insurance.
The study was conducted by collecting the addresses, insurance types, and ethnicity of hospitalized children (18 or younger) with pneumonia. 810 children participated in this survey, all of whom lived in the MMA. This information was mapped out and analyzed for clusters of pneumonia cases. This was then compared with maps of particulate matter (PM), specifically PM2.5, to find correlations between the clusters of pneumonia cases and hotspots of PM2.5 pollution. PM2.5 are tiny particles with a width of 2.5 micrometers or less in the air and come from vehicle exhaust, burning fuels, and smoke. For reference, the average human hair is 100 micrometers in width.
A recent research article, published by the Society for Experimental Biology and Medicine, examined how some of these social determinants of health affect rates of pneumonia. The researchers specifically studied how air quality, race/ethnicity, and insurance type influenced the rates of community-acquired pneumonia (CAP) amongst children in the Memphis Metropolitan Area (MMA). They measured the air quality based on the amount of particulate matter found in the air, specifically small matter from the combustion of diesel and gas and the burning of biomass and coal. Insurance type was used as an indicator of sorts for socioeconomic status: private and public insurance were the two types compared, with private insurance correlated with higher socioeconomic status than public insurance.
The study was conducted by collecting the addresses, insurance types, and ethnicity of hospitalized children (18 or younger) with pneumonia. 810 children participated in this survey, all of whom lived in the MMA. This information was mapped out and analyzed for clusters of pneumonia cases. This was then compared with maps of particulate matter (PM), specifically PM2.5, to find correlations between the clusters of pneumonia cases and hotspots of PM2.5 pollution. PM2.5 are tiny particles with a width of 2.5 micrometers or less in the air and come from vehicle exhaust, burning fuels, and smoke. For reference, the average human hair is 100 micrometers in width.
Image Source: xdigitalphotos
Comparing address, race, insurance type, and risk of pneumonia revealed various trends and connections. The study found children living at addresses in areas with high PM2.5 were more likely to develop pneumonia, presumably because of the lower air quality. When examining race and ethnicity, it found that non-Hispanic Black children and Hispanic children had higher incidences of pneumonia compared with White children in the study. The major factor that race and ethnicity are associated with is home address: Hispanic and non-Hispanic Black children in the study were more likely to live in areas of high PM2.5. Insurance type, used to indicate socioeconomic status, was also tied to prevalence of pneumonia. Those with public insurance were more likely to develop pneumonia and live in an area with high PM2.5.
Overall, this study demonstrated how race and insurance type are intertwined with the addresses and areas children live in and interact with. The higher the PM2.5 exposure in an area is, the greater the risk of developing pneumonia. Hispanic and non-Hispanic Black children were more likely to live in high-risk areas for CAP, compared with White children. Children with public insurance were also more likely to live in these high-risk areas, as opposed to privately insured children. While this study established a concrete argument and explained its findings, it also had numerous limitations. One of the most significant was the small sample size—only 810 children were studied, a number not nearly representative of the entire MMA. Additionally, socioeconomic status was not directly measured. The use of insurance type and race/ethnicity as proxies for socioeconomic status was a generalization and may have affected the findings of this study.
Overall, this study demonstrated how race and insurance type are intertwined with the addresses and areas children live in and interact with. The higher the PM2.5 exposure in an area is, the greater the risk of developing pneumonia. Hispanic and non-Hispanic Black children were more likely to live in high-risk areas for CAP, compared with White children. Children with public insurance were also more likely to live in these high-risk areas, as opposed to privately insured children. While this study established a concrete argument and explained its findings, it also had numerous limitations. One of the most significant was the small sample size—only 810 children were studied, a number not nearly representative of the entire MMA. Additionally, socioeconomic status was not directly measured. The use of insurance type and race/ethnicity as proxies for socioeconomic status was a generalization and may have affected the findings of this study.
Featured Image Source: BruceEmmerling
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