title: Using Address Information to Identify Hardships Reported by Families of Children Hospitalized With Asthma.
abstract: Socioeconomic hardship is common among children hospitalized for asthma but often not practically measurable. Information on where a child resides is universally available. We sought to determine the correlation between neighborhood-level socioeconomic data and family-reported hardships.
  
  
  
  Caregivers of 774 children hospitalized with asthma answered questions regarding income, financial strain, and primary care access. Addresses were geocoded and linked to zip code-, census tract-, and block group-level (neighborhood) data from the US Census. We then compared neighborhood median household income with family-reported household income; percentage of neighborhood residents living in poverty with family-reported financial strain; and percentage of neighborhood households without an available vehicle with family-reported access to primary care. We constructed heat maps and quantified correlations using Kendall rank correlation coefficient. Receiver operator characteristic curves were used to assess predictive abilities of neighborhood measures.
  
  
  
  The cohort was 57% African American and 73% publicly-insured; 63% reported income <$30,000, 32% endorsed ≥4 financial strain measures, and 38% reported less than adequate primary care access. Neighborhood median household income was significantly and moderately correlated with and predictive of reported household income; neighborhood poverty was similarly related to financial strain; neighborhood vehicle availability was weakly correlated with and predictive of primary care access. Correlations and predictions provided by zip code measures were similar to those of census tract and block group.
  
  
  
  Universally available neighborhood information might help efficiently identify children and families with socioeconomic hardships. Systematic screening with area-level socioeconomic measures has the potential to inform resource allocation more efficiently.
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; James M. Anderson Center for Health Systems Excellence, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: Katherine.Auger@cchmc.org.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Auger
authors.affiliation: James M. Anderson Center for Health Systems Excellence, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kahn
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; James M. Anderson Center for Health Systems Excellence, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Simmons
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Anita N
authors.initials: AN
authors.lastname: Shah
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Kristen
authors.initials: K
authors.lastname: Timmons
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Beck
mesh_terms: D000293:Adolescent; D001741:Black or African American; D001249:Asthma; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D062305:Geographic Mapping; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006760:Hospitalization; D006801:Humans; D007182:Income; D007348:Insurance, Health; D008297:Male; D011203:Poverty; D011320:Primary Health Care; D012111:Residence Characteristics; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States; D044465:White People
keywords: asthma; geography; pediatrics; social determinants of health