AIR POLLUTION, RACE, SES & ASTHMA HOSPITALIZATION RISK

描述（改编自申请人摘要）：我们建议进行 估计这种关联如何被种族/民族、社会经济 位置、严重程度、年龄和性别。我们的假设是，亚组和/或 弱势群体将更容易受到环境空气的影响 污染 研究环境为北方和南方的Kaiser Permanente（KP） 加州，一个大型的管理式医疗机构， 5.2万人.案件将被定义为金伯利进程成员， 1997年至2000年期间因哮喘（ICD-9 493）诊断住院 （n= 11，800）。人种/种族、年龄和性别将从Kaiser获得 永久数据库，而社会经济数据将通过地理编码获得 并与美国人口普查信息相关联。严重性将根据利用率得出 KP数据库环境空气污染和气象数据将 从环境监测站确定。暴露和气象因素 将被映射到地理区域和分配给每个人的暴露 根据他或她的居住地址。 将比较每个个体与事件相关的暴露量， 在参考日使用条件logistic回归估计 与暴露于环境空气污染相关的哮喘住院治疗。 调整潜在混杂因素（如气象学和相互作用）后 种族/民族、年龄、性别、疾病严重程度和社会经济地位 将被审查。这将是第一个这样的流行病学研究， 这些因素中的大多数都是基于整个人口的。 这项研究将解决以前研究不足的问题，如果结果 证明少数民族和/或生活在社会经济地位较低地区的人 环境空气污染对健康造成急性影响的风险更高， 研究和政策影响。

DESCRIPTION (Adapted from applicant's abstract): We propose to conduct estimate how this association is modified by race/ethnicity, socioeconomic position, severity, age, and gender. Our hypothesis is that subgroups and/or disadvantaged populations will be more vulnerable to the effects of ambient air pollution. The study setting is Kaiser Permanente (KP) in Northern and Southern California, a large managed care organization with a base population of over 5.2 million people. Cases will be defined as members of KP who were hospitalized with a diagnosis of asthma (ICD-9 493) between 1997 and 2000 (n=11,800). Race/ethnicity, age and gender will be obtained from Kaiser Permanente databases, while socioeconomic data will be obtained by geocoding and linking to US census information. Severity will be derived from utilization databases in KP. Ambient air pollution and meteorologic data will be ascertained from ambient monitoring stations. Exposure and meteorologic factors will be mapped to the geographic areas and exposure assigned to each individual based on his or her residential address. Exposure related to the event for each individual will be compared to exposures on reference days using conditional logistic regression to estimate the risk of an asthma hospitalization associated with exposure to ambient air pollution. After adjusted for potential confounders, such as meteorology, and interactions with race/ethnicity, age, gender, disease severity, and socioeconomic position will be examined. This will be the first such epidemiologic study to look at most of these factors on a population-wide basis. This study will address a previously understudied question and if the results demonstrate that minorities and/or people living in lower SES areas are at higher risk for acute health effects from ambient air pollution, there will be research and policy implications.