541 - Relationship Between Neighborhood Characteristics and E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) in Adolescents: an Ecological Study
Saturday, April 23, 2022
3:30 PM – 6:00 PM US MT
Poster Number: 541 Publication Number: 541.242
Harin Lee, University of Texas Southwestern Medical School, Dallas, TX, United States; Sitara Weerakoon, University of Texas Health Science Center, Dallas, TX, United States; Bayan Mustafa N. Abdallah, University of Texas Southwestern Medical School, Irving, TX, United States; Sarah E. Messiah, University of Texas Health Science Center, School of Public Health, Dallas, TX, United States; Devika R. Rao, University of Texas Southwestern Medical School, Dallas, TX, United States
Medical Student University of Texas Southwestern Medical School Dallas, Texas, United States
Background: In 2019, an acute form of lung injury known as e- cigarette, or vaping, product use-associated lung injury (EVALI) was described. It has been shown that increased socioeconomic status (SES) and advertising efforts are associated with e-cigarette use. However, no study to date has explored neighborhood-level characteristics as potential predictors for EVALI.
Objective: In this study, our aim was to investigate associations between identified adolescent EVALI cases and ZIP code level SES characteristics and vape shop density.
Design/Methods:
Adolescents under 19 years hospitalized for treatment of EVALI at Children’s Medical Center Dallas from December 2018-June 2021 and corresponding ZIP codes were retrospectively identified from electronic health records. ZIP codes containing no EVALI cases were identified through the American Community Survey (ACS) 2019 data and matched to the EVALI case ZIP codes 2:1 using population size and age distribution. SES-related characteristics were selected from the ACS 2019 data and mapped at ZIP code level using ESRI ArcMap geospatial processing software. Chi-square test of independence was used to assess differences by ZIP code group (EVALI/no EVALI).
Results:
Compared to ZIP codes without EVALI cases, ZIP codes containing EVALI cases had a lower percent of the population with a high school diploma or higher (80% vs. 86%) and private health insurance (60% vs. 67%). They also had a greater percent of the population with no health insurance (20% vs. 16%, p< 0.05 for all). No significant difference in vape shop density was found between the ZIP codes with and without EVALI cases (0.24 shops/mi2 vs. 0.30 shops/mi2, p=0.98).
Conclusion(s): Low SES characteristics were found to be significantly associated with EVALI, whereas vape shop density was not. Further research should investigate the association between other neighborhood characteristics and EVALI with the goal of developing a predictive model for EVALI risk that will allow for the implementation of targeted primary and secondary prevention programs in most at-risk neighborhoods.
Harin Lee CVPAS H Lee CV.pdf Neighborhood SES markers and ZIP codes containing EVALI