The State of California Office of Statewide Health Planning and Development collects hospital discharge diagnoses annually in California. For this study, we address discharges associated with childhood (ages 0-14) asthma (ICD code 493) hospitalizations in San Diego County for 1990. Of particular interest is the potential exacerbating effect of exposure to automobile exhaust. Using traffic density as a surrogate for exposure to automobile pollutants, we obtain data on street locations and traffic flow for the county. These data are linked to ZIP code level socio-economic characteristics from the U.S. Census using a geographic information system (GIS). We conduct exploratory spatial analyses for patterns in the asthma data. Based on the exploratory results we fit generalized linear mixed models to assess effects of putative risk factors. The models allow residual spatial correlations, which we use to assess model fit and motivate model improvements.

This is joint work with Erin Conlon, Li Zhu, Paul English and Rusty Scalf.

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