The relationship between neighborhood economic deprivation and community-acquired pneumonia related admissions in Maryland.

Oluwasegun Akinyemi, Mojisola Fasokun, Eunice Odusanya, Terhas Weldeslase, Ofure Omokhodion, Miriam Michael, Kakra Hughes
Author Information
  1. Oluwasegun Akinyemi: Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, United States.
  2. Mojisola Fasokun: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States.
  3. Eunice Odusanya: Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, United States.
  4. Terhas Weldeslase: Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, United States.
  5. Ofure Omokhodion: Department of Epidemiology, John Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
  6. Miriam Michael: Department of Internal Medicine, Howard University College of Medicine, Washington, DC, United States.
  7. Kakra Hughes: Department of Surgery, Howard University College of Medicine, Washington, DC, United States.

Abstract

Introduction: Community-acquired pneumonia (CAP) is a major health concern in the United States (US), with its incidence, severity, and outcomes influenced by social determinants of health, including socioeconomic status. The impact of neighborhood socioeconomic status, as measured by the Distressed Communities Index (DCI), on CAP-related admissions remains understudied in the literature.
Objective: To determine the independent association between DCI and CAP-related admissions in Maryland.
Methods: We conducted a retrospective study using the Maryland State Inpatient Database (SID) to collate data on CAP-related admissions from January 2018 to December 2020. The study included adults aged 18-85 years. We explored the independent association between community-level economic deprivation based on DCI quintiles and CAP-related admissions, adjusting for significant covariates.
Results: In the study period, 61,467 cases of CAP-related admissions were identified. The patients were predominantly White (49.7%) and female (52.4%), with 48.6% being over 65 years old. A substantive association was found between the DCI and CAP-related admissions. Compared to prosperous neighborhoods, patients living in economically deprived communities had 43% increased odds of CAP-related admissions.
Conclusion: Residents of the poorest neighborhoods in Maryland have the highest risk of CAP-related admissions, emphasizing the need to develop effective public health strategies beneficial to the at-risk patient population.

Keywords

References

  1. Front Cell Infect Microbiol. 2022 Sep 07;12:980868 [PMID: 36159650]
  2. FEBS J. 2022 Feb;289(4):883-900 [PMID: 33624419]
  3. BMC Infect Dis. 2021 Sep 14;21(1):949 [PMID: 34521380]
  4. JAMA. 2024 Apr 16;331(15):1318-1319 [PMID: 38506835]
  5. Ann Med Surg (Lond). 2023 Apr 26;85(6):2291-2297 [PMID: 37363608]
  6. Lung India. 2018 Jul-Aug;35(4):284-289 [PMID: 29970765]
  7. Lancet Planet Health. 2022 Nov;6(11):e870-e879 [PMID: 36370725]
  8. Postgrad Med. 2010 Mar;122(2):130-41 [PMID: 20203464]
  9. Med Sci (Basel). 2018 Apr 30;6(2): [PMID: 29710871]
  10. Eur Respir J. 2008 May;31(5):1061-7 [PMID: 18448502]
  11. Front Allergy. 2024 Jun 05;5:1381184 [PMID: 38903705]
  12. Infect Immun. 1997 Jan;65(1):257-60 [PMID: 8975920]
  13. BMJ Open Respir Res. 2021 Mar;8(1): [PMID: 33664125]
  14. Adv Ther. 2020 Apr;37(4):1302-1318 [PMID: 32072494]
  15. Intern Emerg Med. 2022 Sep;17(6):1575-1588 [PMID: 35852675]
  16. Chest. 2019 Feb;155(2):409-416 [PMID: 30419235]
  17. Appl Health Econ Health Policy. 2013 Jun;11(3):251-8 [PMID: 23605251]
  18. Infect Dis Poverty. 2023 Jan 30;12(1):5 [PMID: 36717939]
  19. Air Qual Atmos Health. 2022;15(1):105-114 [PMID: 34539932]
  20. N Engl J Med. 2023 May 25;388(21):1931-1941 [PMID: 36942789]
  21. Arch Bronconeumol (Engl Ed). 2019 Jul;55(7):351-352 [PMID: 30583917]
  22. Int J Environ Res Public Health. 2019 Jan 20;16(2): [PMID: 30669511]
  23. Cold Spring Harb Perspect Biol. 2014 Sep 04;6(10):a016295 [PMID: 25190079]
  24. Pharmacoecon Open. 2021 Jun;5(2):275-284 [PMID: 33225412]
  25. Lancet Reg Health West Pac. 2023 Nov 20;42:100968 [PMID: 38022712]
  26. Clin Infect Dis. 2017 Nov 13;65(11):1806-1812 [PMID: 29020164]
  27. Am J Epidemiol. 2012 Mar 1;175(5):363-7 [PMID: 22247048]
  28. Infect Dis Poverty. 2023 May 16;12(1):51 [PMID: 37194092]
  29. Brain Commun. 2022 Feb 16;4(2):fcac036 [PMID: 35350551]
  30. Health Care Financ Rev. 2000 Summer;21(4):75-90 [PMID: 11481746]
  31. Am J Respir Crit Care Med. 2018 Sep 15;198(6):700-701 [PMID: 29652172]
  32. Public Health Rep. 2020 May/Jun;135(3):364-371 [PMID: 32228396]
  33. Epidemiology. 2009 Nov;20(6):902-8 [PMID: 19797966]
  34. PLoS One. 2020 Dec 23;15(12):e0244367 [PMID: 33362262]
  35. Am J Public Health. 2011 Dec;101 Suppl 1:S37-52 [PMID: 22028451]
  36. J Comp Eff Res. 2020 Jan;9(2):127-140 [PMID: 31840552]
  37. Epidemiol Infect. 2019 Jan;147:e212 [PMID: 31364575]
  38. Eur Respir J. 2017 Jan 11;49(1): [PMID: 28077473]
  39. Infect Dis Poverty. 2014 Apr 24;3:14 [PMID: 24834348]

MeSH Term

Humans
Maryland
Community-Acquired Infections
Female
Middle Aged
Aged
Male
Adult
Pneumonia
Retrospective Studies
Aged, 80 and over
Adolescent
Hospitalization
Young Adult
Neighborhood Characteristics
Residence Characteristics
Socioeconomic Factors

Word Cloud

Created with Highcharts 10.0.0admissionsCAP-relatedhealthDCIMarylandpneumoniasocioeconomicneighborhoodassociationstudyeconomicdeprivationCAPdeterminantsstatusindependentpatientsneighborhoodspopulationcommunity-acquiredIntroduction:Community-acquiredmajorconcernUnitedStatesUSincidenceseverityoutcomesinfluencedsocialincludingimpactmeasuredDistressedCommunitiesIndexremainsunderstudiedliteratureObjective:determineMethods:conductedretrospectiveusingStateInpatientDatabaseSIDcollatedataJanuary2018December2020includedadultsaged18-85 yearsexploredcommunity-levelbasedquintilesadjustingsignificantcovariatesResults:period61467casesidentifiedpredominantlyWhite497%female524%486%65 yearsoldsubstantivefoundComparedprosperouslivingeconomicallydeprivedcommunities43%increasedoddsConclusion:Residentspooresthighestriskemphasizingneeddevelopeffectivepublicstrategiesbeneficialat-riskpatientrelationshiprelateddistressedcommunityindexdisparities

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