[MA 2024 04] Paediatric Asthma: Tracing Health in socioeconomic and environmental Struggles: The PATHS Study
Paediatric Intensive Care Unit, Emma Children’s Hospital, Amsterdam UMC, Amsterdam
Proposed by: Berber Kapitein, paediatric intensivist [b.kapitein@amsterdamumc.nl]
Introduction
Disparities in health are increasing in the Netherlands. A recent meta-analysis of our research group revealed that severe acute asthma in children has a higher prevalence amongst children from poor socioeconomic circumstances (SEC). Severe acute asthma in children for which admission to a paediatric intensive care unit (PICU) is necessary, is an increasing problem worldwide and can result from poor disease control. This can be caused, amongst others, by several factors such as poor drug adherence and underestimation of disease severity and disease control. All these factors can be influenced by poor SEC. Whereas several studies from the United States indeed reveal associations with poor SEC and severity of childhood asthma, Dutch, and even European data are lacking. With a geocoding system using the publicly available data of the Central Bureau of Statistics (CBS), we want to investigate how often children admitted to a Dutch PICU with severe acute asthma grow up in poor social-economic circumstances. We will enrich our existing retrospective cohort of children admitted to a Dutch PICU for severe acute asthma (between 2014-2023) with publicly available data from the Central Bureau of Statistics (CBS). The main objective of this study is to see whether admissions for severe acute asthma at the PICU correlate with poor SEC. The secondary objective is to see whether poor socioeconomic circumstances influence the morbidity as measured by length of stay and necessity for mechanical ventilation, and/ or mortality. Results of the study will be published in a peer reviewed journal and will be discussed with policy makers in a round the table discussion. With these outcomes we will lay foundations not only for further research into the role of SEC on the development and aggravation of childhood asthma but also raise awareness for policymakers that we need more interventions than just drugs to treat childhood asthma.
Description of the SRP Project/Problem
By a national collaboration between all paediatric intensive cares in the Netherlands (7 in total) we obtained a large cohort of children with severe acute asthma. Based on the postal-codes of the admitted patients, data will be linked to publicly available data of the CBS, the open data portal of the police (for neighborhood crime levels), and the Dutch site Atlas voor Leefomgeving (Atlas Leefomgeving | Atlas Leefomgeving), all on level of neighborhood. Amongst others, the following data will be extracted distance to general practioner, distance to highway, distance to foliage (green spaces), housing type, and socio-economic status by the SES-WOA score. This is a composite score on socio-economic values based on financial wellbeing (W), education level (O), past labor history (A). Data are retrieved trough webscraping of mentioned websites based on either the 4 or 6 digits of the postal code. Postal codes of simulated controls will be generated selecting random postal codes. The student would need to develop a way to combine all postal-codes with the different available databases and the clinical data available of all patients. Furthermore, a model should be generated to see which social determinants of health are risk factors for severe acute asthma and need to be addressed for interventions by society and policymakers.
Research questions
Overall aim: In this study we want to investigate whether we can correlate admissions for severe acute asthma at a PICU in the Netherlands to poor socioeconomic circumstances. We want to build a map depicting relative and absolute risk of severe acute asthma in children in the Netherlands.
Primary objective: the influence of composite scores of social determinants of health on the development of severe acute asthma in children compared to the general pediatric population.
Secondary objective: the influence of composite scores of social determinants of health on to mortality and morbidity (by length of stay and mechanical ventilation) in severe acute asthma in children.
Expected results
1. A map depicting relative and absolute risk of severe acute asthma in children in the Netherlands
2. A relative risk predicting AI model for severe asthma potentially leading to PICU admittance or death, given address data.
Time period, please tick at least 1 time period
o November – June
X May - November
Contact
Berber Kapitein, paediatric intensivist, b.kapitein@amsterdamumc.nl
References
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