CalEnviro Screen 2.0: Spatially modeled, age-adjusted rate of emergency department (ED) visits for asthma per 10,000 (averaged over 2007-2009)

California Office of Statewide Health Planning and Development (OSHPD) California Environmental Health Tracking Program (CEHTP) Environmental Health Investigations Branch, California Department of Public Health.

Since 2005, hospitals licensed by the state of California to provide emergency medical services are required to report all emergency department (ED) visits to OSHPD. Federally-owned facilities, including Veterans Administration and Public Health Services hospitals are not required to report. The ED dataset includes information on the principal diagnosis, which can be used to identify which patients visited the ED because of asthma.
ED utilization does not capture the full burden of asthma in a community because not everyone with asthma requires emergency care, especially if they receive preventive care, avoid asthma triggers and undertake disease maintenance. However, there is limited state-wide monitoring of other indicators, such as planned and unplanned doctor’s visits, that might provide a better indication of overall disease burden. Some ED visits result in hospitalization, and OSPHD collects data on hospitalization due to asthma in addition to emergency department visits. ED visits are thought to provide a better comparative measure of asthma burden than hospitalizations and deaths because the data capture a larger portion of the overall burden and include less severe occurrences.
 
CEHTP used OSHPD’s data to calculate age-adjusted rates of asthma ED visits for California ZIP codes. These estimates make use of ZIP-code level population estimates from a private vendor (Esri) and the U.S. 2000 Standard Population to derive age-adjusted rates. Age-adjustment takes the age distribution of a population into account and allows for meaningful comparisons between ZIP codes with different age structures.

Sensitivity Analysis of the CalEnviroScreen Model and Indicators: OEHHA applied a series of statistical analyses, as well as simpler numerical and graphical comparisons, to answer questions about the CalEnviroScreen model and the confidence in the results. The results of the sensitivity analysis on the January 2013 draft that informed the finalization of Version 1.0 of the CalEnviroScreen are presented in this document. The California Environmental Protection Agency (Cal/EPA) and the Office of Environmental Health Hazard Assessment (OEHHA) announce the availability of the California Communities Environmental Health Screening Tool, Version 1 (CalEnviroScreen 1.0). This tool presents the nation’s first comprehensive screening methodology to identify California communities that are disproportionately burdened by multiple sources of pollution and presents the statewide results of the analysis using the screening tool. A report describing the methodology and results along with an online mapping application are available.