Dataset Information

Cross-sectional analysis of place-based and racial disparities in hospitalisation rates by disease category in California in 2001 and 2011.

ABSTRACT:

Objectives

To study the association of place-based socioeconomic factors with disease distribution by comparing hospitalisation rates in California in 2001 and 2011 by zip code median household income.

Design

Serial cross-sectional study testing the association between hospitalisation rates and zip code-level median income, with subgroup analyses by zip code income and race.

Participants/setting

Our study included all hospitalised adults over 18 years old living in California in 2001 and 2011 who were not pregnant or incarcerated. This included all acute-care hospitalisations in California including 1632 zip codes in 2001 and 1672 zip codes in 2011.

Primary and secondary outcomes

We compared age-standardised hospitalisations per 100 000 persons, overall and for several disease categories.

Results

There were 1.58 and 1.78 million hospitalisations in California in 2001 and 2011, respectively. Spatial analysis showed the highest hospitalisation rates in urban inner cities and rural areas, with more than 5000 hospitalisations per 100 000 persons. Hospitalisations per 100 000 persons were consistently highest in the lowest zip code income quintile and particularly among black patients.

Conclusion

Hospitalisation rates rose from 2001 to 2011 among Californians living in low-income and middle-income zip codes. Integrating spatially defined state hospital discharge and federal zip code income data provided a granular description of disease burden. This method may help identify high-risk areas and evaluate public health interventions targeting health disparities.

SUBMITTER: Raphael E

PROVIDER: S-EPMC6830629 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

Cross-sectional analysis of place-based and racial disparities in hospitalisation rates by disease category in California in 2001 and 2011.

Raphael Eva E Gaynes R R Hamad Rita R

BMJ open 20191028 10

<h4>Objectives</h4>To study the association of place-based socioeconomic factors with disease distribution by comparing hospitalisation rates in California in 2001 and 2011 by zip code median household income.<h4>Design</h4>Serial cross-sectional study testing the association between hospitalisation rates and zip code-level median income, with subgroup analyses by zip code income and race.<h4>Participants/setting</h4>Our study included all hospitalised adults over 18 years old living in Californ ...[more]

PMID: 31662392

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Project description:ObjectiveTo study the magnitude and direction of city-level racial and ethnic differences in poverty and education to characterise health equity and social determinants of health in California cities.DesignWe used data from the American Community Survey, United States Census Bureau, 2006-2010, and calculated differences in the prevalence of poverty and low educational attainment in adults by race/ethnicity and by census tracts within California cities. For race/ethnicity comparisons, when the referent group (p2) to calculate the difference (p1-p2) was the non-Hispanic White population (considered a historically advantaged group), a positive difference was considered a health inequity. Differences with a non-White reference group were considered health disparities.SettingCities of the State of California, USA.ResultsWithin-city differences in the prevalence of poverty and low educational attainment disfavoured Black and Latinos compared with Whites in over 78% of the cities. Compared with Whites, the median within-city poverty difference was 7.0% for Latinos and 6.2% for Blacks. For education, median within-city difference was 26.6% for Latinos compared with Whites. In a small, but not negligible proportion of cities, historically disadvantaged race/ethnicity groups had better social determinants of health outcomes than Whites. The median difference between the highest and lowest census tracts within cities was 14.3% for poverty and 15.7% for low educational attainment. Overall city poverty rate was weakly, but positively correlated with within-city racial/ethnic differences.ConclusionsDisparities and inequities are widespread in California. Local health departments can use these findings to partner with cities in their jurisdiction and design strategies to reduce racial, ethnic and geographic differences in economic and educational outcomes. These analytic methods could be used in an ongoing surveillance system to monitor these determinants of health.

Dataset Information

Cross-sectional analysis of place-based and racial disparities in hospitalisation rates by disease category in California in 2001 and 2011.

Objectives

Design

Participants/setting

Primary and secondary outcomes

Results

Conclusion

Publications

Cross-sectional analysis of place-based and racial disparities in hospitalisation rates by disease category in California in 2001 and 2011.

Similar Datasets

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