Health Disparities
Tree cover, health care access, Sociome Data Commons, and pediatric asthma: Chicago, 2010-2019 Sandra Tilmon* Sandra Tilmon Sanjay Krishnan Julia Solway Ellen Cohen Sam Volchenboum
Background
Pediatric asthma exacerbations remain a critical public health concern, particularly in historically underserved urban settings. In Chicago, non-Hispanic Black children 5-19 years old had 2.5 times the emergency visits for asthma as non-Hispanic White children.
Objective
This study investigates sociome factors – the social context of disease – associated with asthma exacerbations among children living in Chicago’s South Side, leveraging clinical and census tract-level datasets. The aim is to uncover novel influences for potential new interventions.
Methods
A multi-level generalized linear model assessed associations while accounting for clustering at the patient level. Parameters (logit or probit_ and correlation structures (independent, exchangeable, and auto-regressive(1)) were tested.
Results
Predictors of decreased risk included patient age (+4.8 years, -22%), tree crown density (+6% coverage, -17%), parks per acre (+0.41, -8%), and labor market engagement (+0.8 points, -9%). Conversely, predictors or increased risk included increased distance to the nearest pharmacy (+0.28 miles, +12%), limited English skills (+2.3%, +10%), higher inequality (+0.08 points, +8%), and visits in the Spring (+11%) and Fall (+20%).
Conclusion
The results suggest that tree crown density, a novel finding in the context of asthma exacerbations, may play a protective role. Limited access to health care facilities such as pharmacies continues to complicate care.
However, the complexity of neighborhood-level influences require broader geographic sampling; limitations include the study’s restricted geographic and demographic scope. Integrating data from multiple hospitals will be essential for replicating these findings and translating them into actionable strategies for improving pediatric asthma care.