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The association of area deprivation and state child health with respiratory outcomes of pediatric patients with cystic fibrosis in the United States
- Source :
- Pediatr Pulmonol
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- BACKGROUND Differences in socioenvironmental exposures influence overall child health, but their association with pediatric cystic fibrosis (CF) outcomes is less clear. This observational study investigated the relationship between area-level socioeconomic deprivation, state child health, and CF respiratory outcomes in a national cohort. METHODS We assessed relationships between the 2015 area deprivation index, a composite measure of socioeconomic disadvantage; the 2016 child health index, a state-specific measure of overall child health; and CF respiratory outcomes in the 2016 CF Foundation Patient Registry. RESULTS The sample included 9934 individuals with CF, aged 6-18 years. In multiple regression analysis adjusted for demographic and clinical covariates, those residing in the worst tertile for area deprivation had 2.8% lower percent predicted forced expiratory volume in 1 s (ppFEV1 ; 95% confidence interval [CI]: -4.1 to -1.5), 1.2 more intravenous (IV) treatment nights (CI: 0.1-2.4), and 20% higher odds of ≥2 pulmonary exacerbations (odds ratio [OR]: 1.2, CI: 1.0-1.5) than best-tertile counterparts. Children with CF in states at the worst tertile for child health had 2.3% lower ppFEV1 (CI: -4.5 to -0.2), 2.2 more IV treatment nights (CI: 0.5-3.6), and 40% higher odds of ≥2 exacerbations (OR: 1.4, CI: 1.1-1.8) than best-tertile counterparts. State child health accounted for the association between area deprivation and multiple exacerbations and more IV treatment nights. CONCLUSIONS Both area socioeconomic characteristics and state child health play a role in pediatric CF outcomes. The residual association of the state child health with CF outcomes after controlling for area deprivation reflects the ability of state programs to mitigate the effect of poverty.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
Cystic Fibrosis
Cystic fibrosis
Article
Odds
03 medical and health sciences
0302 clinical medicine
Forced Expiratory Volume
030225 pediatrics
Humans
Medicine
Respiratory system
Child
Lung
Socioeconomic status
Poverty
business.industry
Child Health
Infant, Newborn
Odds ratio
medicine.disease
United States
Confidence interval
Respiratory Function Tests
030228 respiratory system
Pediatrics, Perinatology and Child Health
Female
Observational study
business
Demography
Subjects
Details
- ISSN :
- 10990496 and 87556863
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Pediatric Pulmonology
- Accession number :
- edsair.doi.dedup.....60e03f1c9fbfe4aad46b059a48583a35