{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:59:26Z","timestamp":1789019966818,"version":"build-2803163510"},"reference-count":72,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T00:00:00Z","timestamp":1586476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Limited work has directly compared the role of different neighborhood factors or examined their interactive effects on pediatric asthma outcomes. Our objective was to quantify the main and interactive effects of neighborhood deprivation and residential instability (RI) on pediatric asthma outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cross\u2010sectional study of patients with a primary diagnosis of asthma hospitalized at a tertiary care pediatric hospital. Residential addresses at the index hospitalization were linked to the state area deprivation index (ADI). RI was coded as the number of residences in the past 4 years. Logistic and ordinal regression and Cox regression survival analyses were used to estimate the effect on the primary outcomes of chronic asthma severity (intermittent, mild persistent, moderate persistent, severe persistent\/other) as defined by the National Heart, Lung, and Blood Institute, severe hospitalization (requiring continuous albuterol or intensive care unit care), and time to emergency department (ED) readmission and rehospitalization within 365 days of the index visit, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the sample (N\u2009=\u2009664), 21% had severe persistent\/other asthma, 22% had severe hospitalization, 37% were readmitted to the ED, and 19% were rehospitalized. Increasing RI was independently associated with more severe chronic asthma (odds ratio\u2009=\u20091.18, 95% confidence interval [CI]\u2009=\u20091.05, 1.32, <jats:italic>P<\/jats:italic>\u2009=\u2009.004), greater risk of 365\u2010day ED readmission (hazard ratio [HR]\u2009=\u20091.10, 95% CI\u2009=\u20091.05, 1.15, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001), and greater risk of 365\u2010day rehospitalization (HR\u2009=\u20091.09, 95% CI\u2009=\u20091.03, 1.14, <jats:italic>P<\/jats:italic>\u2009=\u2009.002). There were no significant associations between ADI and these outcomes. Further, we did not find significant evidence of interactive effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RI appears to be modestly associated with pediatric asthma outcomes, independent of current neighborhood deprivation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24771","type":"journal-article","created":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T17:58:55Z","timestamp":1586541535000},"page":"1340-1348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Residential instability, neighborhood deprivation, and pediatric asthma outcomes"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-4467","authenticated-orcid":false,"given":"Adolfo L.","family":"Molina","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hospital Medicine University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamil\u00e9","family":"Molina","sequence":"additional","affiliation":[{"name":"School of Public Health, Division of Community Health Sciences University of Illinois at Chicago  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4094-2217","authenticated-orcid":false,"given":"Susan C.","family":"Walley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hospital Medicine University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang L.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hospital Medicine University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aowen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine University of Alabama at Birmingham  Birmingham Alabama"},{"name":"Department of Sociology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4052-1524","authenticated-orcid":false,"given":"Gabriela R.","family":"Oates","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,10]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1","article-title":"Trends in asthma prevalence, health care use, and mortality in the united states, 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