Community
Urbanization and Hospitalization of Adults for Asthma
Speaker: Rosemarie G Ramos, PhD, MPH
NIH Postdoctoral Fellow, NIEHS
Level of Knowledge: Basic
Short Abstract:
Few studies have assessed the incidence of adult asthma
hospitalizations in urban vs. non-urban areas.
Using population size, population density, and traffic-related factors
to define urban vs. non-urban environments, six Pennsylvania counties were selected to test
the hypothesis that the degree of urbanization influences the asthma
hospitalization rate for adults. To
define traffic-related urbanization, daily vehicular traffic count and miles of
roads/highways for each of the 6 counties were used. We found, in some of the counties, a decrease
in the adult asthma hospitalization rate as urbanization decreased. However, for other counties, the rate
increased as urbanization decreased. The
counties in which the latter was observed had depressed measures of
socio-economic status (SES) and were located "downwind" of industrial
facilities in Pennsylvania
and neighboring states. Our findings
suggest that other factors may supersede exposure to local traffic-related
pollution in those hospitalized for asthma.
Long Abstract:
Asthma research has traditionally focused on children and
the elderly, two populations considered the most susceptible to
complications. However, the prevalence
of asthma in the adult population (19-64 years) is gaining recognition as a
formidable clinical and public health problem.
In addition, few studies have assessed the incidence of adult asthma
hospitalizations in urban vs. non-urban areas.
Of interest is whether traffic-related and air quality characteristics
associated with urban environments increase the risk of respiratory disease
morbidity when compared to non-urban environments. Using population size, population density,
and traffic-related factors to define urban vs. non-urban environments, six Pennsylvania counties
were selected to test the hypothesis that the degree of urbanization influences
the asthma hospitalization rate for adults.
The study group was comprised of adults, 19-64 years, who were
hospitalized for asthma (as the primary diagnosis) from 1999-2001. To define
urbanization related to traffic, daily vehicular traffic count and miles of
roads/highways for each of the 6 counties were used. We found, in some of the counties, a decrease
in the adult asthma hospitalization rate as urbanization decreased. However, for other counties, the rate
increased as urbanization decreased. The
counties in which the latter was observed had depressed measures of
socio-economic status (SES). In
addition, these areas appear to be "downwind" of industrial
facilities within the state of Pennsylvania
and its neighboring states. Our findings
suggest that depressed socioeconomic conditions and regional air quality may
supersede exposure to local traffic-related pollution with respect to asthma
hospitalizations.
Learning Objectives:
- Address how designations
of urban versus rural are made in the US
- Appreciate the multifactorial nature of asthma
- Realize the research
barriers with respect to assessing the relationship of regional ambient
air quality and respiratory health morbidity