Interventions with social risk linked to fewer emergency room visits for asthma, hospitalizations in children
December 15, 2021
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Source / Disclosures
Disclosures: Tyris does not report any relevant financial disclosure. Please see the study for relevant financial information from all other authors.
In children with asthma, socially risky interventions were associated with reduced emergency room visits and asthma-related hospitalizations, researchers in JAMA Pediatrics.
âTo date, existing asthma interventions have not been categorized using the framework of the social determinants of health for healthy people,â Jordan Nicolas Tyris, MD, a hospital medicine fellow in the division of hospital medicine at Children’s National Hospital and the George Washington University School of Medicine and Health Sciences in Washington, DC, told Healio. “In addition, their impact on the use of asthma health care from a social risk perspective had not been quantitatively synthesized.”
Tyris and colleagues searched PubMed, Scopus, PsycINFO, SocINDEX, and CINAHL from January 2008 to June 2021 for US-based studies that assessed associations of interventions addressing one or more social risks with emergency room visits and asthma-related hospitalizations in children. Of the 641 articles identified, the systematic review included 38 and the meta-analysis included 19, with a total of 5,441 participants.
Using Healthy People 2020’s social determinants of health framework, researchers identified intervention groups using cluster studies based on the social risks addressed. All of the socially risky interventions included in these studies focused on one or more of the areas of health (n = 35), environment (n = 21) and community (n = 15).
Researchers observed an association between socially risky interventions and a decrease in asthma-related emergency room visits (RR = 0.68; 95% CI: 0.57-0.81) and hospitalizations (RR = 0.5; 95% CI 0.37-0.68) in the primary meta-analysis. In a subgroup analysis, the health, environment and community intervention group was associated with the lowest risk of asthma-related emergency room visits (RR = 0.53; 95% CI: 0.44- 0.64) and hospitalizations (RR = 0.33; 95% CI 0.2-0.55) compared to other social risk intervention groups.
“Asthma interventions that address the social risks of individual patients – in particular, those that focus on improving health literacy, access to health care, sanitation of the home environment and peer support – were associated with reduced health care use in children with asthma in our review, âTyris told Healio.
Looking ahead, âwe know that managing the social risks of each family will not affect the underlying social determinants at the population level. Instead, population level policies are needed to change social determinants, âTyris said. âWe recommend prioritizing the evaluation of these policies and specifically studying their impact on health outcomes in children. “
For more information:
Jordan nichole Tyris, MARYLAND, can be contacted at [email protected]