Children's study finds higher rates of childhood illness in poor neighborhoods across Hamilton Co.

New research from Cincinnati Children’s Hospital Medical Center reaffirms the connection between neighborhood resources and health issues.
 
Dr. Andrew F. Beck, assistant professor in UC’s Department of Pediatrics and attending physician with the Department of Pediatrics at Children’s Hospital, studied bronchiolitis and pneumonia cases in children across Hamilton County and mapped out hospitalization stays over the course of the study period. He calculated hospitalization rates by census tract, which in essence parallel neighborhood boundaries.
 
Andrew F. Beck MD“Bronchiolitis is a very common lower respiratory tract infection among children age 0 to 2 and pneumonia is one of the most common infectious conditions across childhood,” Beck says. “We found some of the same disparities across our community as we have seen in our research on asthma and life expectancy study published by the Health Department. There is a lot of data suggesting that there are disparities in chronic conditions, and now we’re seeing these disparities in acute infections as well.”
 
The study indicates that hospitalizations for bronchiolitis and pneumonia infections vary widely across Hamilton County, and those differences appear related to neighborhood socio-economic conditions. The study reported hot spots with higher hospitalization rates in high-poverty areas of the inner city, with equivalent cold spots in the more affluent northeastern suburbs.
 
“The depiction of these disparities is a call to action on multiple fronts,” Beck says. “There is a strong desire here to understand difference and disparities within our neighborhood settings across a wide breadth of diagnoses. The related desire is to begin to understand the characteristics of those communities: what are the risks within those communities and what are the assets, resources and potential partners within those communities that we could then leverage moving forward.”
 
Beck and his Children’s colleagues have a strong track record of pursuing research and intervention in tandem.
 
Over the past few years, Children’s has worked closely with Freestore Foodbank to address food insecurity in families with infants, providing not only medical intervention but also educational opportunities and resources to improve quality of life. Children’s also partnered with the Legal Aid Society of Greater Cincinnati to launch the Cincinnati Child Health-Law Partnership, providing legal council and assistance to families struggling with legal issues related to housing and income or health benefits.
 
“I like to consider myself an expert in child health,” Beck says. “But I am not an expert in housing or hunger or air pollution or those factors that may be exacerbating the well-being of the kids I’m treating. So it behooves me to think through who are those key community partners that might actually drive more health improvement than I might as the pediatrician. That’s why we really value collaborations with community agencies that are those experts.”
 
The recent research by Beck and his colleagues on hospitalization rates for bronchiolitis, pneumonia and asthma shows there is a relationship but not a causality between these illnesses and poverty. Beck anticipates additional research will be done to examine the possible sources of the disparities.
 
“We need to do a better job understanding why some of our kids are doing worse than others and then think through what the best next steps are and how this data can spawn action,” he says. “(It’s important) both as a hospital trying to provide the best care we can to every kid within our community and in every neighborhood within our community and also to help start conversations with some of these community experts and agencies that may play an even larger role than we could.”
 
Health statistics are often provided on a macro level, with rankings of the most and least healthy regions, states or counties. Beck and his colleagues are examining the data at more micro level.
 
“Even if there are big disparities between County X and County Y, you need to look at a smaller, more granular place,” Beck says. “Because within County X, there may be disparities that need to be narrowed. So we’re trying to understand how we can help our kids do well across communities, not just as an aggregated community.”
 
Beck and the Department of Pediatrics at Children’s are open to new collaborations to build on the success of their relationships with Legal Aid and Freestore Foodbank.
 
“The list goes on and on for potential partners who are truly the experts in the social determinants that are perhaps driving the disparities that we see across all these conditions,” Beck says. “We need to think through our complimentary strengths, our complimentary needs and how can we collaboratively provide a better service than we could in isolation.”