In response to a need for standardizing measurement and tracking of health equity outcomes in childhood asthma, researchers created a health equity index that re-envisions how equity-related data and metrics are collected.
A recent grant-funded pilot project at Rady Children’s Health Network (RCHN) in Rancho Santa Fe, California, developed a dashboard that can help reduce disparities in childhood asthma resulting from poor social determinants of health (SDOH). In response to a need for standardizing the measurement and tracking of health equity outcomes, project researchers created an asthma health equity index that re-envisions how equity-related data and metrics are collected and displayed.
The index includes location (geo-mapping), race and ethnicity, language, payor type, household income, prior emergency department visits, SDOH factors, and school information. This index is a promising prototype for other healthcare sectors and medical disciplines to better serve communities enduring health disparities. The patients served using this dashboard and index were primarily Hispanic (56.1%) and non-Hispanic Black or other (23.2%). These patients belong to communities where health disparities due to socio-environmental barriers, such as poverty and air quality, are well-documented.
The index was tested by calling households in which children with poorly controlled asthma had recent emergency department visits. The patient care coordinator conducting the calls identified potential links between disparities and SDOH factors through screenings that examined the possibility of food insecurity, housing instability, transportation access, and tobacco use. Families contacted were also given adequate follow-up and asthma education, as needed.
The collected data were compiled by a population health clinical informaticist and included SDOH and demographic information to build a health equity index that would identify, track, and prioritize care gaps. The index would also support the development of interventions for all the children seen in the hospital’s emergency department for asthma.
The results of the index showed that racial and ethnic identities of patients were strongly linked with food insecurity, housing instability, and tobacco use (all P < .001). The results also showed that language access was strongly associated with food insecurity and housing instability (both P < .001) in addition to transportation barriers (P = .05) Additionally, patients screened who were Hispanic, Black, or identified with another racial or ethnic minority were three to 5 times more likely to experience housing instability (P < .001) when compared to White patients who were screened. Hispanic patients were 3 times more likely to experience food insecurity (P < .001) and transportation barriers than White patients, and Black patients were twice as likely to experience tobacco use or exposure to smoke from tobacco use.
The article concludes with a call to action for healthcare workers, providers, and clinicians to commit to understanding the impact that social determinants of health have on their patients from racial and ethnic minority communities, and to develop a collaborative community ecosystem with community partners to better understand their needs and barriers. By doing so, interventions designed for these patients will be more effective and have greater impact on vulnerable populations that need critical attention and care.
Source
Inserro, A. (2022). Dashboard Portrays SDOH Factors Affecting Children With Severe Asthma. Retrieved from https://www.ajmc.com/view/dashboard-portrays-sdoh-factors-affecting-children-with-severe-asthma
