Chronic lower respiratory diseases associated with health disparities in New York City

A new cross-sectional study from New York found that chronic lower respiratory disease (CLRD) outcomes were significantly associated with health disparities at the state county level.

In 2019, the Centers for Disease Control and Prevention (CDC) reported that CLRD caused 47.8 deaths per 100,000 population, making it the fourth leading cause of death.

With their study, Yu-Che Lee, MD, MPH, Department of Medicine, University of Buffalo, Jacobs School of Medicine and Biomedical Sciences, and other researchers examined and provided insight into the association between CLRD findings and health disparities in New York State. .

The methods

For the present study, the researchers used the age-adjusted hospitalization rates of CLRD per 10,000 population for 2016 and death rates per 100,000 population for 2014 to 2016 from the Health Indicator Reports. New York State Community Center, which was provided by the New York State Department of Health.

Additionally, county health rankings were used to rate a myriad of health factors to provide a summary z score for each county representing the county’s health status and its rank within the state.

The county’s overall health factor ranking was calculated based on a weighted sum of z scores for each health factor in 4 categories, including 30% for health behaviors (smoking, diet and exercise, alcohol and drug use and sexual activity), 20% for clinical care (access to health and quality of care), 40% for social and economic factors (education, employment, income, family and social support and community security) and 10% for the physical environment (air and water quality, housing and public transport).

From there, the team calculated correlations between county-level health factor z scores and CLRD hospitalization and death rates using Pearson r.

Univariate (UVA) and multivariable (MVA) linear regression analyzes were used to determine associations between health factors at the county level. z CLRD score and hospitalization and mortality rates, all variables reported in UVA as either significantly associated with CLRD outcomes or were strongly correlated in preliminary analyzes (Pearson r > 0.3 or r

The results

Over the course of the study, the team noted 60,335 discharges that were documented as hospitalizations at CLRD in 2016, as well as 20,612 CLRD-related deaths that occurred from 2014 to 2016 in New York state.

After adjustment for age, the CRRD hospitalization rate was 27.6 per 10,000 inhabitants, with a mortality rate of 28.9 per 100,000 inhabitants.

Among the 62 counties included in the study, the Bronx had the highest hospitalization rate (64.7 per 10,000 population), while Hamilton had the lowest hospitalization rate (6.6 per 10,000 residents).

Data from the county health rankings indicated that the country of Nassau had the lowest z score at -1.17, while the Bronx had the highest z score (the least healthy), at 1.43, for the factors of global health in 2018. An increase of 1 point of the social and economic factors z score was associated with an increase of 17.6 hospitalizations per 10,000 inhabitants (β = 17.61 [95% CI, 10.36 to 24.87]; P <.001>

“The CLRD results were significantly associated with health disparities at the county level,” the team wrote. “These results suggest that public health interventions and resources aimed at improving CLRD outcomes should be tailored and prioritized in poor health areas,” the team wrote.

The study, “Association of Chronic Lower Respiratory Disease with Health Disparities in New York State Counties, ”Was published online in JAMA Open Network.

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