Investigators within the Division of General Pediatrics have been working to better understand the social determinants of asthma and ways to intervene to mitigate socioeconomic risks. Adapting ideas from social economists, Jeff Simmons, MD, and Robert Kahn, MD, PhD, have measured “financial strain” that is associated with a four-fold gradient of asthma readmission risk and is a more important predictor of readmission than race or insurance status. Financial strain is measured with seven simple questions such as whether a family had to borrow money or move in with others during the past year. Their fellow, Andrew Beck, MD, has found strong correlations between a family’s financial strain and neighborhood measures of socioeconomic risk based on census data and found a 20-fold gradient of asthma admission risk between different neighborhoods in Cincinnati.
These clinician-researchers have used these insights to contribute to institutional multidisciplinary asthma quality improvement work lead by Mona Mansour, MD, MS, and Carolyn Kercsmar, MD, MS (pulmonary). Many interventions have been implemented that have resulted in children with Medicaid having 30-day and 90-day readmission rates that have decreased by 45 percent and 25 percent, respectively. Analyses of this work, funded by a Cincinnati Beacon Communities grant, are ongoing.
