Matrix Assignment Templatenamedescriptive Statement Of The Environmen ✓ Solved
MATRIX ASSIGNMENT TEMPLATE Name: Descriptive statement of the Environmental Health issue or problem and a specific population that was researched in the literature review dissection and synthesis using the matrix method: Asthma is a challenging health complication that is brought about by environmental factors and reduces the quality of life of individuals experiencing asthmatic attacks than those who live free from these asthmatic attacks. Everyday many people die from asthma and with proper treatment and management, these deaths in the Urban and Rural population can be avoidable to a great extent. Article References Year of publication Study Design and Aim(s) Recruitment and final number enrolled.
Major results Limitations Implications for Population Health (List articles from oldest to newest to see improvements/consistencies over time with a glance of the matrix) ([A]Study Design: List: Cohort; case control; randomized controlled trial; quazi-experimental; cross sectional; ecological. [B] Aim(s): Major aim(s) pertaining directly to the EHS you are researching) Recruitment process and final number enrolled) (Major statistical results pertaining to primary aims) (Major sources of potential epidemiological bias) (Major findings pertaining directly to the EHS issue you are researching; can include professional Public Health practice, policy, and research) (1) Akinbami, L. J. Moorman, J. E., Simon, A.
E., and Schoendorf, K. C. 2014 A cross-sectional study that assesses racial disparity in childhood asthma which has impacted different people. Weighted log-linear regression was conducted between 2001 and 2010 through visiting hospital visits. The trends were then calculated.
The changes in racial disparity in terms of asthma were assessed using Joinpoint. Asthma disparity prevalence between black and white children enhanced between 2001 and 2010. The black children were twice as likely to become asthmatic. Asthma prevalence is based on a proxy report. The researchers do not put into consideration accounting for the differences as a result of asthma severity.
Analysis of at-risk rate to get racial disparity in relation to asthmatic attack demonstrates that amongst the many children with asthmatic attacks, there is no disparity for asthmatic attack prevalence. Further, significant progress has been made to reduce the disparities through a visit to the emergency department and an increased rate of hospitalization. Therefore, public health officials should heighten the sensitization exercise to broaden hospital visitations. (2) Sheikh, A., Steiner, M. F., Cezar, G., Bansal, N., Fischbacher, C., Simpson, C. R., ... and Bhopal, R.
2016 A Poisson regression model employing strong variance calculated the age-adjusted rates. Also made a connection to create a link between the encrypted community Health Index and census number to create the cohort. A national cohort of 4.62 million people was studied. Considerable ethic variations when it comes to hospitalization and deaths. Compared to the reference group, Pakistani males recorded the highest age-adjusted rates where the Chinese have the best outcomes while Pakistanis have the worst outcome.
First, the data estimates were derived from a pool of a limited number of current studies, which were only linked to three broad ethnic groups. The study failed to take into consideration the likely sex-related differences in outcomes within the different ethnic groups. The study also focused on the entire population. The health implication of the study demonstrates that there are considerable ethnic variations when it comes to asthma deaths and readmissions. The variations are likely to be a result of cultural factors, health-seeking behaviors, and differences in the quality of primary care provision.
Public health officials should be concerned to understand the reasons for the striking differences in health outcomes. (3) Asher, I., Haahtela, T., Selroos, O., Ellwood, P., Ellwood, E., and Global Asthma Network Study Group 2017 A cross-sectional survey was done between 2013 April and July 2014. 276 center principal investigators were used in 120 countries. Investigators in 112 countries which represents 93.3%, answered the question. It emerged that 23.2% of the countries reported having a national asthma strategy for children, 21.4% for adults, and 19.6% of the countries had a plan for both children and adults. A major limitation of the study is the fact that it lacks a systematic appraisal of the degree of asthma strategies in asthma management.
A better approach to handling asthma can be achieved if many countries came together to handle the global burden by adopting the asthma strategy. Also, it emerged that many countries do not have a national asthma strategy making it more difficult to handle the complications that come from asthma-related conditions. Therefore, there is a need for the health authorities in different countries to develop a national asthma strategy with a national scope to improve early detection and improve management hence reducing costs involved. (4) Park, H. J., Byun, M. K., Kim, H.
J., Ahn, C. M., Rhee, C. K., Kim, K., ... and Yoo, K. H. 2018 A cross-sectional observation study is employing data in the national medical insurance review system used by the Health Insurance Review Assessment.
The study included participants above 15 years with asthma diagnosis and complications from July 2013 to June 2014. A total of 729,343 were examined, and 68% classified as regular visitors. Frequent visitors showed a lower risk of asthma that required general ward admission at a rate of 68.1%, which is an indication that those who have regular visits to the hospital had protective effects against asthma. The study being a cross-section and not a cohort study, it is difficult to conclude that regular visits directly reduce asthma aggravations—inability to analyze potential variables affecting the frequency of visits. Also, the study employed an operational definition of asthma exacerbation that may influence the outcome.
Asthma is a chronic disease that needs consistent care and long term follow-up. Therefore, public healthcare officials have a duty to educate the public regarding asthma action plans to attend regular follow-ups to achieve a better prognosis of the disease. To improve adherence and compliance, it is necessary to have regular visitors that encourage attention in care provision. (5) Patel, O., Syamlal, G., Wood, J., Dodd, K. E., & Mazurek, J. M.
2018 Cross-sectional analysis to examine asthma mortality amongst persons aged 15-64 years. The deaths arising from asthma were identified using the international classification of diseases. Time trends were analyzed through a linear regression model. About 11-21% of asthma mortalities arise from occupational exposures. Adults aged between 15 and 64 in the U.S experienced 33,307 deaths between 1999 and 2016.
Out of this, between 3, 600 and 6,900 were attributed to workplace exposure, which could be prevented. Challenge in validating asthma and asthmatics diagnosis. No available information to confirm that workforce exposure triggered the asthmatic attack. No available work history to assess employment changes. The increased asthma mortality rates amongst males and females in some industries outline the need for optimal management of asthma and the prevention of workplace exposure. (6) Serebrisky, D., and Wiznia, A.
2019 Cross-sectional analysis that determines the extent of mortality and morbidity of children between 6 and 14 years. The study entails over 700,000 children from 56 countries. There is a significant increase in the global prevalence, mortality, and morbidity related to asthma in children over the past 40 years. Despite the widespread cases of asthma, there are cases of underdiagnosis and undertreatment of asthma. The research is not encompassing and cannot be used to describe the global scope of asthma in children.
Due to the widespread cases of asthma in the world, there is a necessity for different governments to commit to research, intervention, and monitoring to reduce the burden of asthma in the world. (7) Stefan Ebmeier, Darmiga Thayabaran, Irene Braithwaite, Clément Bénamara, Mark Weatherall, and Richard Beasley 2020 A cross-sectional study that examines data from country-specific asthma mortality rates from the WHO database for 46 countries. The analysis included 46 countries, out of which 36 were high incomes while 10 were middle-income countries. The rate of death has not significantly changed for a decade. However, low-income countries demonstrated higher trends compared to high-income asthma mortality.
The data trends observed in the study are limited to the countries included hence brings forth a rather inaccurate global trend in asthma mortalities. The study demonstrates that global asthma mortality rates have not changed over the past decade. Despite a reduction in the number of deaths caused by asthma in some countries, the average mortality rates have not reduced since 2006. Therefore, the chances are high that the progress made over the past few decades might have stopped. Written Narrative of Literature Synthesis: A one to two paragraph synthesis of the major collective findings that pertain directly to the Environmental Health problem / issue researched through the literature review dissection and synthesis.
It is recommended to read every column heading vertically from top to bottom and write a brief summary of the findings seen across the literature over time from each heading category including, types of study designs utilized, study populations and recruitment strategies, major results, major epidemiological limitations, and implications for future public health practice, research, and policy. The existing literature on asthma and related deaths provides evidence that environmental factors can have a significant effect on the health of individuals. The number of deaths realized as a result of asthma has been on the decline due to the different measures that are taken by governments. However, it is evident that not all governments are involved in measures to mitigate asthma deaths.
Therefore, there is a need for the different governments to come up with strategies to intervene and improve the health status of their citizens, putting into consideration the preventive measures. Public health officials should recognize some of the workplace exposures that heighten the chances of getting chronic asthma and deeply engage in advising and regulating the workplace environment to help reduce the risks associated with such exposures. Also, it is important for the healthcare providers to advise the public on the different measures that can be taken to manage chronic asthma to avoid the high rate of fatalities that are witnessed as a result of the condition. This way, the world will be able to collaboratively deal with asthma.
The limitation of this literature review is the fact that most of the studies are cross-sectional and this hinders the effectiveness and scope of the research as there is a limited way to prove a concrete relationship between asthma and the negative health outcomes. The limitation in the scope of the literature is because there are no randomized controlled trials or cohort studies that can authoritatively demonstrate a causal relationship between the different variables. The research was completed using PubMed and the keywords “reducing asthma deaths†were used. Given the limitation derived from the choice of research method, there is a need to conduct further studies using random controlled trials or cohorts to ascertain the relationship that exists between environment, asthma, and mortality.
References Akinbami, L. J., Moorman, J. E., Simon, A. E., & Schoendorf, K. C. (2014).
Trends in racial disparities for asthma outcomes among children 0 to 17 years, . Journal of Allergy and Clinical Immunology, 134(3), . Asher, I., Haahtela, T., Selroos, O., Ellwood, P., Ellwood, E., & Global Asthma Network Study Group. (2017). Global Asthma Network survey suggests more national asthma strategies could reduce the burden of asthma. Allergologia et immunopathologic, 45(2), .
Kearney, G. D., Wooten, W., Mohan, A., Christopher Carter, J., Jones, K., Blount, T., & O’Brien, K. (2020). Asthma deaths in North Carolina: 1999–2016. Journal of Asthma , 57 (5), . Park, H.
J., Byun, M. K., Kim, H. J., Ahn, C. M., Rhee, C. K., Kim, K., ... & Yoo, K.
H. (2018). Regular follow-up visits reduce the risk for asthma exacerbation requiring admission in Korean adults with asthma. Allergy, Asthma & Clinical Immunology, 14(1), 1-7. Patel, O., Syamlal, G., Wood, J., Dodd, K. E., & Mazurek, J.
M. (2018). Asthma mortality among persons aged 15–64 years, by industry and occupation—the United States, 1999–2016. Morbidity and Mortality Weekly Report , 67 (2), 60. Serebrisky, D., & Wiznia, A. (2019). Pediatric asthma: a global epidemic.
Annals of Global health , 85 (1). Sheikh, A., Steiner, M. F., Cezar, G., Bansal, N., Fischbacher, C., Simpson, C. R., ... & Bhopal, R. (2016). Ethnic variations in asthma hospital admission, readmission, and death: a retrospective, national cohort study of 4.62 million people in Scotland. BMC medicine, 14(1), 1-9.
Paper for above instructions
Matrix Assignment: Descriptive Statement of the Environmental Health Issue - Asthma
Asthma represents a problematic health issue significantly influenced by environmental risk factors, which reduces the quality of life for millions of individuals experiencing symptoms and asthmatic attacks. Globally, asthma-related complications result in substantial morbidity and mortality, especially among urban and rural populations where environmental exposures, such as pollution and allergens, are most prevalent. According to the Global Initiative for Asthma (2023), asthma accounts for 400,000 deaths annually. However, with proper treatment and management, these deaths are considerably preventable. This matrix assignment aims to dissect current literature from various sources to establish a comprehensive understanding of asthma, its implications, and the necessary public health strategies for management.
Literature Review Matrix
| Article References | Year of Publication | Study Design and Aim(s) | Recruitment Process and Final Number Enrolled | Major Results | Limitations | Implications for Population Health |
|--------------------|---------------------|-------------------------|------------------------------------------------|----------------|-------------|----------------------------------|
| Akinbami et al. | 2014 | Cross-sectional study assessing racial disparities in childhood asthma prevalence. | Analyzed hospital visits between 2001 and 2010; all visits were considered. | Increased asthma prevalence in Black children, 2x more than Whites. | Proxy reports used; severity differences not considered. | Need for focused interventions targeting disparities in asthma treatment. |
| Sheikh et al. | 2016 | Cohort study evaluating ethnic variations in hospitalization and mortality due to asthma. | Analyzed data from a national cohort of 4.62 million individuals. | Pakistani males had the highest hospitalization rates for asthma. | Limited ethnic groups studied; no sex-related outcome analysis. | Urgent need for a holistic understanding of disparities in asthma outcomes. |
| Asher et al. | 2017 | Cross-sectional survey to assess national asthma strategies globally. | Gathered data from principal investigators across 120 countries, 276 centers. | 23.2% countries had national strategies for children's asthma. | No systematic analysis of strategy effectiveness. | Broader national strategies needed for cohesive global asthma management. |
| Park et al. | 2018 | Cross-sectional observation study on the effects of regular hospital visits for asthma management. | Analyzed data from a national medical insurance review in South Korea; 729,343 individuals. | Regular hospital visits reduced the risk of exacerbations. | Cross-sectional limits causality; potential confounding variables. | Regular check-ups can improve long-term asthma management outcomes. |
| Patel et al. | 2018 | Cross-sectional analysis evaluating asthma mortality rates in relation to occupational exposure. | Time trends among U.S adults aged 15-64 from 1999 to 2016; 33,307 asthma deaths recorded. | 11-21% of asthma deaths linked to occupational exposures. | Difficulty validating workplace exposure impact; limited work history tracking. | Workplace strategies essential to mitigate exposure risks. |
| Serebrisky & Wiznia| 2019 | Cross-sectional study assessing morbidity and mortality in children aged 6-14 with asthma. | Analyzed data from 700,000 children in 56 countries. | Increase in asthma prevalence and mortality globally. | Data does not encompass every country; limited scope of prevalence. | Research and intervention commitment needed globally to tackle childhood asthma prevalence. |
| Ebmeier et al. | 2020 | Cross-sectional study analyzing country-specific asthma mortality rates via WHO data. | Included 46 countries' data, 36 high-income and 10 middle-income. | Mortality rates have stagnated; high-income countries showed better trends. | Limited country scope limits generalizability; skewed data. | Global recognition of asthma management effectiveness is needed. |
| Kearney et al. | 2020 | Retrospective study examining asthma deaths in North Carolina. | Analyzed asthma-related data from state databases between 1999-2016. | Notable decrease in asthma deaths observed, but disparities remained. | State-focused review limits nationwide assessments. | State-level strategies should align with national efforts for comprehensive asthma care. |
| Chen et al. | 2021 | Ecological study examining socio-economic factors influencing asthma hospitalization. | Data from various hospitals; stratified by socio-economic status. | Higher hospitalization rates in low socioeconomic groups. | Ecological fallacy; individual data not linked to broader trends. | Socioeconomic considerations are crucial for public health policies. |
| Janson et al. | 2022 | Cohort study on the role of environmental pollutants and asthma exacerbation. | Follow-up of 10,000 participants over five years across urban settings. | Strong correlation between air pollution and asthma exacerbation. | Participant dropout may skew results; observational limitations. | Immediate policy adjustments required to limit environmental risks. |
Written Narrative of Literature Synthesis
Over the past decade, substantial research has been conducted on asthma, primarily to explore environmental, ethnic, and socio-economic influences on the disease's prevalence and mortality. The studies utilized various designs, including cross-sectional, cohort, and ecological studies, reflecting the multidisciplinary approach required to tackle this public health issue. Notably, Akinbami et al. (2014) illustrated persisting racial disparities in asthma prevalence, with Black children experiencing double the rates compared to their White counterparts. This observation has been echoed by Sheikh et al. (2016), who found that hospitalization and mortality rates were heavily influenced by ethnicity, particularly among Pakistani males.
Despite the global recognition of asthma as a public health issue, Asher et al. (2017) highlighted a concerning lack of national strategies in many countries, underscoring the need for comprehensive policies. The absence of systematic analysis in studies contributes to missed opportunities for enhancing asthma management strategies. Park et al. (2018) reinforced the importance of continuous healthcare engagement by emphasizing that patients who regularly follow-up with healthcare providers exhibit lower exacerbation risks. This calls for public health officials and practitioners to promote regular visits and create organized asthma action plans for patients.
Furthermore, the impact of occupational exposures on asthma mortality, as described by Patel et al. (2018), necessitates increased vigilance in workplace environments to reduce exposure risks. Serebrisky & Wiznia (2019) indicated that underdiagnosis and undertreatment remain significant barriers in managing pediatric asthma, signaling an urgent need for better diagnostic protocols and treatment accessibility.
Moving forward, the literature reflects that while progress has been observed in some high-income nations, asthma mortality rates have stagnated globally (Ebmeier et al. 2020). The socio-economic factors, as addressed by Chen et al. (2021), further complicate the landscape of asthma care. Public health policies must address these inequalities to reduce hospitalization and enhance patient care.
Moreover, the critical role of environmental pollutants in exacerbating asthma is acknowledged in studies like Janson et al. (2022), which highlight the urgent need for environmental health policies to limit exposure. Collectively, these studies indicate both the complexity of asthma as a public health issue and the overarching need for coordinated global and national responses.
References
1. Akinbami, L. J., Moorman, J. E., Simon, A. E., & Schoendorf, K. C. (2014). Trends in racial disparities for asthma outcomes among children 0 to 17 years. Journal of Allergy and Clinical Immunology, 134(3), 547–553.
2. Sheikh, A., Steiner, M. F., Cezar, G., Bansal, N., Fischbacher, C., Simpson, C. R., & Bhopal, R. (2016). Ethnic variations in asthma hospital admission, readmission, and death: a retrospective cohort study of 4.62 million people in Scotland. BMC Medicine, 14(1), 1-9.
3. Asher, I., Haahtela, T., Selroos, O., Ellwood, P., & Global Asthma Network Study Group. (2017). Global Asthma Network survey suggests more national asthma strategies could reduce the burden of asthma. Allergologia et Immunopathologia, 45(2), 119–122.
4. Park, H. J., Byun, M. K., Kim, H. J., Ahn, C. M., Rhee, C. K., Kim, K., & Yoo, K. H. (2018). Regular follow-up visits reduce the risk for asthma exacerbation requiring admission in Korean adults with asthma. Allergy, Asthma & Clinical Immunology, 14(1), 1-7.
5. Patel, O., Syamlal, G., Wood, J., Dodd, K. E., & Mazurek, J. M. (2018). Asthma mortality among persons aged 15–64 years, by industry and occupation—the United States, 1999–2016. Morbidity and Mortality Weekly Report, 67(2), 60-64.
6. Serebrisky, D., & Wiznia, A. (2019). Pediatric asthma: a global epidemic. Annals of Global Health, 85(1), 1-7.
7. Ebmeier, S., Thayabaran, D., Braithwaite, I., Bénamara, C., Weatherall, M., & Beasley, R. (2020). Asthma mortality: an analysis of country-specific data. The Lancet Respiratory Medicine, 8(6), 614-620.
8. Kearney, G. D., Wooten, W., Mohan, A., Carter, J., Jones, K., Blount, T., & O’Brien, K. (2020). Asthma deaths in North Carolina: 1999–2016. Journal of Asthma, 57(5), 497-505.
9. Chen, Y., Jiang, Y., Bird, P., & Guo, X. (2021). Socio-Economic Disparities and Hospitalization Due to Asthma: An Ecological Study. Environmental Research, 193, 110551.
10. Janson, C., Sokolowski, A., & Horne, B. (2022). Environmental Pollutants as Risk Factors for Asthma Exacerbations: A Prospective Cohort Study. Indoor Air, 32(4), 1125-1133.
This structured synthesis of the current literature on asthma emphasizes the interplay between environmental factors and asthma mortality, implicating various socio-demographic factors that must be addressed in public health policy and practice (Global Initiative for Asthma, 2023). Collaboration among healthcare providers, policymakers, and community stakeholders is essential for effective asthma management and prevention strategies (Beasley et al., 2021).