Rationale: The share of Black or Latinx residents in a census tract remains associated with asthma-related emergency department (ED) visit rates after controlling for socioeconomic factors. The extent to which evident disparities relate to the within-city heterogeneity of long-term air pollution exposure remains unclear. Objectives: To investigate the role of intraurban spatial variability of air pollution in asthma acute care use disparity. Methods: An administrative database was used to define census tract population-based incidence rates of asthma-related ED visits. We estimate the associations between census tract incidence rates and 1) average fine and coarse particulate matter, nitrogen dioxide (NO2), and sulfur dioxide (SO2), and 2) racial and ethnic composition using generalized linear models controlling for socioeconomic and housing covariates. We also examine for the attenuation of incidence risk ratios (IRRs) associated with race/ethnicity when controlling for air pollution exposure. Measurements and Main Results: Fine and coarse particulate matter and SO2 are all associated with census tract-level incidence rates of asthma-related ED visits, and multipollutant models show evidence of independent risk associated with coarse particulate matter and SO2. The association between census tract incidence rate and Black resident share (IRR, 1.51 [credible interval (CI), 1.48-1.54]) is attenuated by 24% when accounting for air pollution (IRR, 1.39 [CI, 1.35-1.42]), and the association with Latinx resident share (IRR, 1.11 [CI, 1.09-1.13]) is attenuated by 32% (IRR, 1.08 [CI, 1.06-1.10]). Conclusions: Neighborhood-level rates of asthma acute care use are associated with local air pollution. Controlling for air pollution attenuates associations with census tract racial/ethnic composition, suggesting that intracity variability in air pollution could contribute to neighborhood-to-neighborhood asthma morbidity disparities.

中文翻译：

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社区空气污染在不同种族和民族哮喘急性护理使用中的作用。


理由：在控制社会经济因素后，人口普查区中黑人或拉丁裔居民的比例仍然与哮喘相关的急诊科 (ED) 就诊率相关。明显的差异在多大程度上与长期空气污染暴露的城市内异质性相关仍不清楚。目的：调查城市内空气污染的空间变异在哮喘急性护理使用差异中的作用。方法：使用管理数据库来确定人口普查区人口中哮喘相关急诊就诊的发生率。我们使用控制社会经济和住房协变量的广义线性模型来估计人口普查区发病率与 1) 平均细颗粒物和粗颗粒物、二氧化氮 (NO2) 和二氧化硫 (SO2) 以及 2) 种族和民族构成之间的关联。在控制空气污染暴露时，我们还检查了与种族/民族相关的发病风险比 (IRR) 的衰减。测量和主要结果：细颗粒物和粗颗粒物以及 SO2 均与人口普查区域内哮喘相关急诊就诊的发病率相关，多污染物模型显示了与粗颗粒物和 SO2 相关的独立风险的证据。考虑到空气污染（IRR，1.39 [CI，1.35-1.42]）时，人口普查区发病率与黑人居民比例（IRR，1.51 [可信区间（CI），1.48-1.54]）之间的关联减弱了 24％，与拉丁裔居民份额（IRR，1.11 [CI，1.09-1.13]）的关联减弱了 32%（IRR，1.08 [CI，1.06-1.10]）。结论：社区一级哮喘急性护理使用率与当地空气污染有关。 控制空气污染会减弱与人口普查区种族/民族构成的关联，这表明城市内空气污染的变异性可能会导致邻里之间的哮喘发病率差异。