A105-10 Sociodemographic Deprivation and Pediatric Asthma Exacerbations: A Ward-Level Analysis in Washington, DC

Rationale Sociodemographic deprivation varies across wards in Washington, D.C, and is associated with adverse health outcomes, such as COVID-19, diabetes, and hypertension. While previous studies have shown that measures of area socioeconomic status are associated with increased pediatric asthma healthcare utilization, few analyses have quantified this association at the ward level. This study quantifies deprivation across D.C. using the Area Deprivation Index (ADI) and measures pediatric asthma burden through pediatric asthma emergency department (ED) visits from 2022-2024. This novel ward-level aggregation of ADI scores may benefit pediatric respiratory health through community-level resource allocation. Methods Deprivation was quantified using ADI, a validated composite measure that weighs 17 socioeconomic indicators, including income, employment, and education. ADI scores range from 1-100, with higher scores representing areas with more deprivation. Within D.C., ADI scores were aggregated at the ward level in deciles. Asthma ED visit rates per 1000 children aged 0-17 years were calculated using population counts from the 2019-2023 American Community Survey and similarly mapped at the ward level for 2022-2024. We dichotomized wards into low-to-moderate deprivation (ADI deciles 1-7) and high deprivation (ADI deciles 8-10) groups to reflect a practical stratification of deprivation extremes to help guide targeted place-based interventions. We used Welch’s t-test at the 5% alpha level when evaluating statistical significance. Results On average across the study period, the annual ED visits per 1000 children in wards with low-to-moderate deprivation and wards with high deprivation were 13.4 (95% CI: 10.2, 16.6) and 26.7 (95% CI: 18.8, 34.6), respectively. The mean difference between high and low-to-moderate deprivation groups was 13.3 (95% CI: 5.28, 21.2). This pattern was consistently demonstrated with the means of 16.11 vs 29.78 ED visits in 2022, 14.77 vs 29.72 visits in 2023, and 9.34 vs 20.50 visits in 2024, reflecting a roughly double increase in asthma ED visit rates in wards with high deprivation across all 3 years. Conclusions Our findings support that neighborhood-level deprivation is associated with pediatric asthma exacerbations and burden, underscoring the importance of considering the influence of socioeconomic factors and geographic location on health outcomes. This study highlights the potential of adapting ADI to create a practical lens to address pediatric asthma disease burden. Future studies should build upon this work to integrate ADI into predictive modeling frameworks to guide place-based preventative care interventions. This abstract is funded by: None