Use of Medicaid and housing data may help target areas of high asthma prevalence

ABSTRACT

Objective: To determine if there was a significant difference between mold contamination and asthma prevalence in Detroit and non-Detroit Michigan homes, between newer and older homes, and if there is a correlation between mold contamination and measures of Medicaid use for asthma in the 25 Detroit zip codes. Methods: Settled dust was collected from homes (n = 113) of Detroit asthmatic children and from a representative group of Michigan homes (n = 43). The mold contamination for each home was measured using the Environmental Relative Moldiness Index (ERMI) scale and the mean ERMI values in Detroit and non-Detroit homes were statistically compared. Michigan Medicaid data (13 measures related to asthma) in each of the 25 zip codes in Detroit were tested for correlation to ERMI values for homes in those zip codes. Results: The mean ERMI value (14.5 ± 8.0) for Detroit asthmatic childrens' homes was significantly (Student's t-test, p < 0.001) greater than the mean ERMI value (2.1 ± 6.2) for the non-Detroit homes. Detroit homes > 60 years old had significantly (p = 0.01) greater mean ERMI values than Detroit homes ≤ 60 years old (15.87 vs. 11.25). The percentage of children that underwent spirometry testing for their persistent asthma (based on Medicaid data) was significantly, positively correlated with the mean ERMI values of the homes in the 25 zip codes. Conclusions: Applying Medicaid-use data for spirometry testing and locating a city's older housing stock might help find foci of homes with high ERMI values.

KEYWORDS:

• Detroit
• mold
• ERMI
• zip code
• Aspergillus
• dust
• home age

Acknowledgments

The authors are grateful to the parents, guardians, and children who participated in the study, which was conducted by the Community Action Against Asthma (CAAA) community-based participatory research partnership. CAAA includes the following organizations: Arab Community Center for Economic and Social Services, Community Health and Social Services Center Inc., Detroit Hispanic Development Corporation, Detroiters Working for Environmental Justice, Friends of Parkside, Institute for Population Health, Southwest Detroit Environmental Vision, Eastside Community Network (formerly the Warren Conner Development Coalition), Wilma Brakefield-Caldwell (community advocate), the University of Michigan's School of Medicine, and the University of Michigan's School of Public Health.

Declaration of interest

The United States Environmental Protection Agency (US EPA) through its Office of Research and Development, collaborated in the research described here. Although this work was reviewed by EPA and approved for publication it may not necessarily reflect official EPA policy. Mention of trade names or commercial products does not constitute endorsement or recommendation by the EPA for use. Since MSQPCR technology is patented by the US EPA, the Agency has a financial interest in its commercial use.

Funding

Funding for this research was provided by grants US EPA (R834117) and NIEHS (5-R01-ES014677).