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New study shows higher rates of asthma hospitalizations in Northeast Lubbock

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Image of an asthma inhaler

Asthma is the most common chronic illness in children and a recent study investigated the geographic disparities in hospitalizations related to the illness in Lubbock County. The study explores the role that race and ethnicity, health insurance and other environmental factors play in these disparities. Texas Tech Public Media sat down with one of the researchers, Dr. Duke Appiah, who worked on this investigation.

Kaysie Ellingson: What sparked this study?

Dr. Duke Appiah: Since I came to Lubbock, I've realized—and also based on what others have told me—that there are some racial, ethnic disparities even in the location of where people live and stuff like that. I was interested to see how that influences health. I didn't start off doing it, but I had a student who was very interested in it, Noah De La Cruz, he was very interested in looking at some of these health conditions. So, our hypothesis was that environmental factors will play a role. And so, because of that, we chose asthma since we know it's a respiratory disease, which can be influenced or have some exacerbations based on some environmental factors. And so, it's based on these things that we decided to look at this association in Lubbock.

Kaysie: Can you explain the research method used in this study?

Appiah: The research method is basically using the Texas inpatient sample data. This is a publicly available data set. We looked at that and then we zeroed in on Lubbock County. Then we divided Lubbock into four regions based on zip codes. So, we had a northeast, the northwest, southeast and the southwest regions. And then we did another analysis after we saw the results, trying to see how environmental factors also play a role. So for that, environmental factors were not broken up into these regions that we had. So, we had to look at it overall for Lubbock. We did an analysis whereby we look at changing trends in PM (particulate matter) 2.5, there's PM 2.5, and how it affects X, serious asthma hospitalizations. And so those were basically like the methods that we use for our study.

Kaysie: PM 2.5, That's basically pollution.

Appiah: It measures in a sense, yes, pollution in the air, but it's not specific to let's say, any chemical or anything like that, but it's more of the size of the particle.

Kaysie: Okay, so it could be a combination of things. What did the results show? And was there anything that was particularly surprising to you?

Appiah: I wouldn't say so surprising. Maybe the estimates that I found were surprising, but the results were basically what I expected. So, our results show that for asthma hospitalizations, and that's when we limited it to serious or severe asthma hospitalizations, we saw that the rates were higher in the Northeast region. So, for instance, if to break it down, if you take one thousand people from let's say, the Northeast region, about seven of them will be hospitalized for asthma compared to other parts of the region, whereby [elsewhere] we had a low of just four. And so even though this number is small, I always tell people, if you really multiply by the actual populations in these regions, you will see that these numbers are a lot. And I forgot to mention that we looked at the trend from 1999 up until 2018. So, we had almost about 20 years’ worth of data for this analysis.

Kaysie: What questions are still unanswered and need to be researched a little further?

Appiah: One of the limitations of our study was that there are some factors that we also know that is associated with asthma hospitalizations—for instance, in the smoking—we couldn't account for that. And as I said previously, we also couldn't have a measure of the air quality in the various regions. And so even when we look at particulate matter and asthma hospitalizations It was mainly for the whole of Lubbock. And so, some of the things that are missing is trying to really get information on air quality in the regions themselves to compare how it affects not just asthma, but other health outcomes, as well as doing other studies to try and understand what makes this group more at risk for disease than the other. And so, if you're talking about things that are missing, these are basically like things that will like to do.

Read full study here:

Kaysie: How does this directly impact communities?

Appiah: This impacts communities because one of the things that I have realized is that a lot of people don't know that where you live can influence your health. It is very important. Even how you interact with people in your neighborhood also has a role to play on your health. And so, where communities live has a role in how healthy you can be. And so, for me and my research team, we want to draw attention to the fact that not everyone is enjoying the wonderful environment of Lubbock as we think some people just based by where they live or based on their socioeconomic status have an adverse outcomes for health conditions than other regions. So, trying to understand why this is the case is a very important research topic for me and for my team as well.

Kaysie: Is there anything else you want to add about this study?

Appiah: First, I'd like to thank you for this opportunity to get our message across and secondly, I also like to thank all my co-authors: Noah De La Cruz, Jonathan Hines, Dr. Chip Shaw. All these are the people who help this project be a success.

Kaysie Ellingson is the former news director for Texas Tech Public Media. She came to Lubbock after living in Anchorage, Alaska, working as a documentary producer for Alaska Public Media. Prior to working in public media, Kaysie earned her master's degree in journalism from the University of Southern California with an emphasis in documentary production.
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