Identifying geographic areas with increased incidence of disease may reveal community-level risk factors for intervention development, according to a study led by researchers at the University of Arizona Mel and Enid Zuckerman College of Public Health and the Arizona Respiratory Center.
The study looked at lower respiratory illnesses (LRIs), which are the leading cause of death in children and are associated with other morbidities. The researchers identified geographic clustering of LRIs and evaluated if these spatial patterns and associated risk factors differed by phenotype.
“Our use of social and environmental indices allowed us to identify broad contextual factors that may contribute to increased incidence of LRIs in specific geographic regions,” said first author Dr. Paloma Beamer, associate professor at the UA Zuckerman College of Public Health and associate scientist with the Arizona Respiratory Center.
Participants enrolled at birth in the Tucson Children’s Respiratory Study were followed through age three for physician-diagnosed LRIs. Spatial clustering analysis, based upon each participant’s birth address, was performed for four LRI phenotypes. Principal component analysis at the census tract level was conducted to generate indices for lower socioeconomic status (SES), poorer housing conditions, and increased air pollution.
Enrollment addresses were mapped for 812 subjects of whom: 58.4% had an LRI; 33.5% a wheezing LRI; 34.2% viral and 23.4% respiratory syncytial virus (RSV) LRI. Patterns of spatial clustering and associated risk factors differed by LRI phenotype. Multivariable regression analyses showed that wheezing LRI clusters were associated with increased air pollution. Being in a viral cluster was associated with poorer housing conditions, while being in a RSV cluster was associated with increased air pollution, poorer housing conditions and higher SES.
The study, “Spatial clusters of child lower respiratory illnesses associated with community-level risk factors,” was first published online in the journal Pediatric Pulmonology, Oct 2015. The article can be accessed at the following link: http://onlinelibrary.wiley.com/doi/10.1002/ppul.23332/abstract