Neighborhood sociome factors and pediatric asthma exacerbations: Protective role of tree crown density and importance of pharmacy access in Chicago's south side.

Background: Pediatric asthma exacerbations remain a critical public health concern, particularly in historically underserved urban settings.

Objective: This study investigates sociome factors-the social context of disease-associated with asthma exacerbations among children living in Chicago's South Side, leveraging clinical and publicly available generalizable census tract-level datasets from agencies including ChiVes, the City of Chicago Data Portal, EPA, Census Bureau, HUD, NOAA, and more. The aim is to uncover novel hypotheses for potential new interventions.

Methods: A generalized linear model assessed associations with the outcome of asthma exacerbations while accounting for clustering at the patient level. Predictors included all variables from the Sociome Data Commons, including social, environmental, behavioral, economic, housing, and school variables.

Results: Predictors of decreased risk included patient age (+4.8 years, -22%), tree crown density (+6% coverage, -17%), parks per acre (+0.41, -8%), and labor market engagement (+0.8 points, -9%). Conversely, predictors of increased risk included increased distance to the nearest pharmacy (+0.28 miles, +12%), limited English skills (+2.3%, +10%), higher inequality (+0.08 points, +8%), and visits in the Spring (+11%) and Fall (+20%).

Conclusion: The results suggest that tree crown density, a novel finding in the context of asthma exacerbations, may play a protective role. Limited access to health care facilities such as pharmacies continues to complicate care.

Clinical implications: These findings provide hypotheses for future interventions for long-standing asthma disparities.