跳至主要内容

Age, Race and Gender Spatiotemporal Disparities of COPD Emergency Room Visits in Houston, Texas

Read  full  paper  at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53779#.VNMYOizQrzE

ABSTRACT
Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality in the United State. The investigation of the continuing increase in its prevalence and mortality has increased attempts to further understand its causes and how to manage it. Understanding the spatial and temporal distribution of COPD emergency room (ER) visits in Harris County (Houston) can guide these efforts in a uniform yet diverse setting like this one. The objectives of this study were to identify the temporal and spatial variations of COPD emergency room visits adjusted by age, gender, ethnicity, day of the week, month, and year, and to estimate the odds ratio of COPD emergency room visits adjusted by the six risk factors. The dataset used were extracted from two resources: ER Utilization Study and Harris County centroid coordinates. Exploratory statistical analyses were conducted to study the spatiotemporal disparities and investigate associations. Logistic regression was performed to estimate the odds ratio of COPD primary diagnosis adjusted for age, race, gender, day of the week, month, and year. The number of COPD ER visits kept increasing from 2004 throughout 2009 but there was a significant increase after the year 2005. Spring and summer had lower visits compared to winter and autumn. Lowest visits were during June and July and higher during December and January. Tuesdays had the highest number of visits compared to the remaining days of the week with Saturdays having had the lowest number of visits. Temporal analyses show the continuous increase in COPD ER visits in Houston as well as the consistent spatial disparities between zip regions. After adjustment for age, race, gender, day of the week, month, and year, there were statistically significant associations between emergency room chronic obstructive pulmonary disease diagnoses in Houston, Texas, with these six predictors.
 
Cite this paper
Anderson, F. , Carson, A. , Whitehead, L. and Burau, K. (2015) Age, Race and Gender Spatiotemporal Disparities of COPD Emergency Room Visits in Houston, Texas. Occupational Diseases and Environmental Medicine, 3, 1-9. doi: 10.4236/odem.2015.31001.
 
References
[1]CDC (1998) Chronic Obstructive Pulmonary Disease. http://www.cdc.gov/niosh/pdfs/98-157-d.pdf
 
[2]NHLBI (2010) What Is COPD. http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html
 
[3]CDC (2010) COPD. http://www.cdc.gov/copd/index.htm
 
[4]EPA (2011) COPD. http://cfpub.epa.gov/eroe/index.cfm?fuseaction=detail.viewPDF&ch=
49&lShowInd=0&subtop=381&lv=list.listByChapter&r=235293
 
[5]Begley, C., Courtney, P. and Burau, K. (2011) Houston Hospitals Emergency Department Use Study. http://www.sph.uth.tmc.edu/uploadedFiles/Redesign_Website/Research/Research_
Centers/Center_for_Health_Services_Research/HSRC/Final2009BegleyMonday.pdf
 
[6]EPA (2011) COPD. http://cfpub.epa.gov/eroe/index.cfm?fuseaction=detail.viewPDF&ch
=49&lShowInd=0&subtop=381&lv=list.listByChapter&r=235293
 
[7]ESRI (2007) Evaluating Population Projections—The Importance of Accurate Forecasting. http://www.esri.com/library/whitepapers/pdfs/evaluating-population.pdf
 
[8]Anderson, W. (2005) Statistical Techniques for Validating Logistic Regression Models. Annals of Thoracic Surgery, 80, 1169.
 
[9]Merrill, R. (2008) Environmental Epidemiology: Principles and Methods. Jones & Bartlett Learning.
 
[10]Sexton, K., Linder, S., Delclos, G., Stock, T., Abramson, S., Bondy, M., et al. (2005) A Closer Look at Air Pollution in Houston: Identifying Priority Health Risks.http://www.epa.gov/ttn/chief/
conference/ei16/session6/bethel.pdf
 
[11]Koerber, K. (2006) Migration Patterns and Mover Characteristics from the 2005 ACS Gulf Coast Area Special Products. http://www.census.gov/newsroom/emergencies/additional/gulf_migration.html
 
[12]Gershon, A., Wang, C., Wilton, A., Raut, R. and To, T. (2010) Trends in Chronic Obstructive Pulmonary Disease Prevalence, Incidence, and Mortality in Ontario, Canada, 1996 to 2007. Archives of Internal Medicine, 170, 560-565. http://dx.doi.org/10.1001/archinternmed.2010.17
 
[13]London, S. (2011) COPD Exacerbations Twice as Common in Winter.
 
[14]Wedzicha, J.A. (2004) Role of Viruses in Exacerbations of Chronic Obstructive Pulmonary Disease. Proceedings of the American Thoracic Society, 1, 115-120. http://dx.doi.org/10.1513/pats.2306030
 
[15]Turpin, B., Clifford, P., Morandi, M., Colome, S., Stock, T., Eisenreich, S., et al. (2007) Relationships of Indoor, Outdoor, and Personal Air (RIOPA): Part II. Analyses of Concentrations of Particulate Matter Species. Research Report (Health Effects Institute), No. 130, 1-77.
 
[16]LUNGUSA (2010) African Americans. http://www.lungusa.org/stop-smoking/about-smoking/facts-figures/african-americans-and-tobacco.html
 
[17]CDC (2012) Eliminate Disparities in Cardiovascular Disease (CVD).
 
[18]Mensah, G. and Brown, D. (2007) An Overview of Cardiovascular Disease Burden in the United States. Health Affairs, 26, 38-48. http://content.healthaffairs.org/content/26/1/38.full                          eww150205lx

评论

此博客中的热门博文

Does Immigration Promote the Investment of the Monopolistic Firm?

In the present paper, we examine the effect of increasing uncertainty of immigrants’ growth on the optimal timing of investment of a firm that has a monopolistic power over the labor market. It is revealed that when the uncertainty of immigrants’ growth is more than a threshold level, increasing uncertainty of immigrants’ growth accelerates the optimal timing of firms’ investment and enhances the economic growth, even if the uncertainty of immigrants’ growth is formulated by the geometric Brownian motion, which is in sharp contrast to the standard result that an increase in the uncertainty postpones the optimal timing. With an increase in the immigrants over the past ten years, workforces in the host countries have been growing significantly to the extent that the immigrants represent 70% of the increase in the workforce in Europe, and 47% in the United States as OECD indicates. In the present paper, we attempted to investigate the effect of increased uncertainty caused by the growi...

Education Policy Implementation: A Mechanism for Enhancing Primary Education Development in Zanzibar

Education is one of the fundamental rights of individuals; therefore, the government of a country needs to develop and strengthen educational policy and quality as well as to ensure that everyone has equal access to basic education. The improvement of access and quality of education in the world is becoming as an essential factor in development, whereas the basic education (primary school), is acknowledged as a foundation of the higher educational development for every country. To fulfill this goal, governments introduce several policies and procedures; however, it requires some reforms and participation from the politician, policymakers, and other stakeholders to re-examine educational policy so that it can lead to multiplication and betterment of the reforms. Educational reforms actually focus on accountability. A positive educational development and reform is very challenging and needs more effort and strategy on how to use and utilize the resources effectively as such it can achie...