PM2104: Where Are the Super Users? Using Geo-mapping to Identify High Risk Asthma Patients in Detroit, MI

Background: In March 2016, the Michigan Department of Health released a report regarding the status of asthma burden in Detroit; it highlighted the health disparities affecting African Americans adults and children with asthma. In their analysis from 2009 to 2013, zip codes in central and eastern Detroit were designated as having the highest rate of pediatric asthma hospitalizations and Emergency Room (ER) visits. The purpose of our project was to identify current “high risk” asthma zip codes and neighborhoods in Detroit from 2015 to 2019, in order to inform asthma-related advocacy and community interventions.

Methods: Geographic Information System (GIS) technologies are an emerging tool in public health used to gather, manage, organize, and conceptualize data. For this study, Children’s Hospital of Michigan (CHM) asthma-related ER, hospital admissions and outpatient visit data from 2015 to 2019 was gathered. The data was plotted using advanced geo-mapping software to identify “high risk” regions.

Results: Using an aggregate of all CHM asthma-related data, we extracted addresses of over 54,000 patient encounters from 2015 to 2019. In total, 5 zip codes in Detroit were identified as “high risk” in terms of overall CHM asthma-related data: 48227, 48228, 48235, 48212, and 48234. Many of these zip codes are clustered on the west side of Detroit. More specifically, 48228 was identified as having the highest number of asthma-related hospital admissions during that time frame, indicating the highest degree of severity. Additionally, we were able to identify “super users” – patients had been admitted 5 or more times in that time frame. In total, these patients accounted for 16% of all asthma admissions during that time. Interestingly, the zip code with the most “super users” was 48228. Within that zip code, Warren and Warren Avenue neighborhoods were found to have the largest numbers of super users. These 2 neighborhoods are surrounded by 3 major roads and a major highway. In addition, they have both been heavily targeted for a nuisance abatement program due to the significant number of suspected drug-related and abandoned homes and properties. Ultimately, we visualized that the highest prevalence of severe asthma exacerbations was in the western part of Detroit, which is in contrast to the Michigan Department of Health study findings in 2016.

Conclusion: Overall, geo-mapping technology can help elucidate trends and patterns related to multifactorial health disparities like asthma. Our data suggests that there may be a more recent temporal trend towards higher rates of asthma in Western Detroit with a significant number of super users identified in 2 neighborhoods in the 48228 zip code. Through existing partnerships with community organizations and the Detroit Public Health Department, we plan to create targeted community-based asthma interventions and advocacy projects.