On the detection of patterns, trends, and distributions of respiratory diseases in Western New York: An analysis of asthma using geographical information systems (GIS)

This study is concerned with the analysis of spatial variations of respiratory diseases in the context of socioeconomic and environmental factors in the Western New York region of the United States. The principal objective is to identify spatial patterns, trends and the distribution of asthma over the past decade using Geographical Information Systems. The study is based on hospitalization, emergency room, and population-based survey data. This study hypothesizes that increased exacerbations of respiratory diseases are associated with increased exposures to pollution substances. A link is suspected between the unusually high rates of asthma and suspected sources of pollution. Low socioeconomic status communities and geographical areas in Western New York have a high respiratory disease burden. The spatial distribution of asthma prevalence and healthcare utilization in the study area is generally non-homogeneous. Asthma diagnosis is observed predominantly in children (5--17 yrs) and adults (18--44 yrs).Two case-control studies are also conducted based on hospitalization and population-based survey data. In the first case-control study, cases (N = 3717) consists of predominantly adult asthmatics and the controls (N = 4129) consists of non-respiratory disease (gastroenteritis) during the same period using data obtained from Kaleida Health database. The second case-control study consists of two school samples of asthmatics (N = 72) and non-asthmatics (N = 251) drawn from a population-based survey conducted in Cheektowaga. In the first case-control study, communities living in close proximity to the Peace Bridge Complex [Odds Ratios (OR) = 4.407, 95% confidence interval (CI) = 3.256--5.967], roadways feeding it [e.g., OR &ge 1.299, CI = 1.015--1.664], and Environmental Protection Agency designated air and multiple emission sites [e.g., OR &ge 1.926, CI = 1.602--2.317] were associated with statistically significant increased odds of having diagnosed asthma but not for non-respiratory disease. Notable spatial asthma clusters were also detected in the study area. Asthma clusters provide a basis for the development of new hypotheses relating to the spatial distribution of asthma prevalence and morbidity in the study area. However, correlations of findings with air quality assessments, especially traffic-related pollution, are required for a definitive link to be made between the increased risk of asthma and identified pollution sources.