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Background: The lack of SARS-CoV-2 antigen surveillance testing in the pediatric population has inhibited accurate infection and hospitalization prevalence estimates. We aim to report the estimated prevalence of and risk factors for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission across the three United States (US) waves in one of the largest pediatric healthcare systems in the nation. Methods: Retrospective electronic health record (EHR) review of all COVID-19 surveillance data among children aged 0–19 years seeking healthcare at one pediatric healthcare system that serves predominantly Medicaid-dependent families from 1 March 2020 to 31 March 2021. COVID-19 infection status (Y/N), hospital admission (Y/N), and ICU admission (Y/N) are the main outcomes. Results: Of 22,377 children aged ≤ 19 years tested for SARS-CoV-2 infection from March 2020–March 2021, 3126 were positive (14.0%), and out of those positive, 53.7% were hospitalized and 2.9% were admitted to the ICU. Compared to Wave 1 (1 March 2020–31 May 2020), the risk of a positive test increased from 16% (RR 1.16, 95% CI, 1.07–1.26) in Wave 2 (1 June 2020–31 October 2020) to 33% (RR 1.33, 95% CI, 1.23–1.44) in Wave 3 (1 November 2020–31 March 2021). Similarly, compared to Wave 1, the risk for hospitalization increased 86% (RR 1.86, 95% CI, 1.86–2.06) in Wave 2 and 89% in Wave 3 (RR 1.89, 95% CI, 1.70–2.08), and the risk for ICU admission increased from 10% in Wave 2 (RR 1.10, 95% CI, 0.39–3.01) to 310% in Wave 3 (RR 3.10, 95% CI, 1.21–7.80). Children with asthma, depressive disorders, type 1 or 2 diabetes, and anemia were more likely to be hospitalized while children with diabetes, obesity, cardiac malformations, and hypertension were more likely to be admitted to the ICU versus children without these conditions. Conclusions: Children were cumulatively impacted by the COVID-19 pandemic through the three US waves with more than a third hospitalized in Wave 3. Children with underlying health conditions were particularly at risk for severe illness and should be monitored for any long-term impacts.
Sarah E. Messiah; Luyu Xie; Matthew S. Mathew; George L. Delclos; Harold W. Kohl; Jeffrey S. Kahn. Results of COVID-19 Surveillance in a Large United States Pediatric Healthcare System over One Year. Children 2021, 8, 752 .
AMA StyleSarah E. Messiah, Luyu Xie, Matthew S. Mathew, George L. Delclos, Harold W. Kohl, Jeffrey S. Kahn. Results of COVID-19 Surveillance in a Large United States Pediatric Healthcare System over One Year. Children. 2021; 8 (9):752.
Chicago/Turabian StyleSarah E. Messiah; Luyu Xie; Matthew S. Mathew; George L. Delclos; Harold W. Kohl; Jeffrey S. Kahn. 2021. "Results of COVID-19 Surveillance in a Large United States Pediatric Healthcare System over One Year." Children 8, no. 9: 752.
BACKGROUND The COVID‐19 pandemic presents unique opportunities for preexisting school telemedicine programs to reach pediatric populations that might otherwise experience a lapse in health care services. METHODS A retrospective analysis of one of the largest school‐based telemedicine programs in the country, based in the Dallas‐Fort Worth (DFW), Texas was conducted that included 7021 pediatric patients who engaged in telehealth visits from 2014 to 2019. RESULTS Asthma or other respiratory disease was the primary diagnosis (28.4%), followed by injury or trauma (18.4%), digestive disorders (6.9%), and ear/eye/skin disease (6.9%). More participants were from the North (34.4%) and West (33.2%) ISD compared to the South (20.6%) and East (11.7%) schools. Likewise, the majority of COVID‐19 cases were in the North (61.8%) and West (31.6%) DFW regions, leading to 989 (59.9%) and 551 (33.4%) deaths, respectively. CONCLUSIONS School‐based telehealth programs have the potential to reach large pediatric populations most in need of health care due to COVID‐19‐related lapses in services, and to address COVID‐19‐related health issues as schools reopen. In the future, utilization could be expanded to contact tracing, testing, and screening for COVID‐19.
Stormee Williams; Luyu Xie; Kristina Hill; Matthew Sunil Mathew; Tamara Perry; Danielle Wesley; Sarah E. Messiah. Potential Utility of School‐Based Telehealth in the Era of COVID ‐19. Journal of School Health 2021, 91, 550 -554.
AMA StyleStormee Williams, Luyu Xie, Kristina Hill, Matthew Sunil Mathew, Tamara Perry, Danielle Wesley, Sarah E. Messiah. Potential Utility of School‐Based Telehealth in the Era of COVID ‐19. Journal of School Health. 2021; 91 (7):550-554.
Chicago/Turabian StyleStormee Williams; Luyu Xie; Kristina Hill; Matthew Sunil Mathew; Tamara Perry; Danielle Wesley; Sarah E. Messiah. 2021. "Potential Utility of School‐Based Telehealth in the Era of COVID ‐19." Journal of School Health 91, no. 7: 550-554.
United States (US) youth consume an average of 10 teaspoons of added sugar from sugar-sweetened beverages (SSB) on any given day. Few population-based studies have examined the association between SSB consumption and asthma in children and adolescents. This study aimed to examine the association between SSB consumption and asthma in the US pediatric population. Analytical cross-sectional study. A total of 9,938 children aged 2-to-17 years old who participated in the 2011-2016 National Health and Nutrition Examination Surveys. SSB consumption was categorized into 3 groups based on the caloric intake from 24-hour food recall data as follows: 1) no consumption (0 kcal/day); 2) moderate consumption (1-499 kcal/day); and 3) heavy consumption (≥ 500 kcal/day). The primary outcome of interest was self-reported current asthma condition. Asthma prevalence estimates were significantly higher in heavy (16.4%) and moderate (11.0%) SSB consumers versus non-consumers (7.5%) (p < 0.05 for both comparisons). The adjusted odds of asthma were twice that among children with heavy SSB consumption (aOR 2.01, 95% confidence interval [CI] 1.31-3.08) versus non-SSB consumers. The odds of asthma were higher among those who consumed fruit drinks (aOR 2.51, 95% CI 1.55-4.08), non-diet soft drinks (aOR 1.89, 95% CI 1.23-2.89) and sweet tea (aOR 1.87, 95% CI 1.13-3.09) compared to nondrinkers. The effect was independent of obesity status (p-interaction = 0.439). Findings here suggest a dose-response relationship between SSB intake and asthma diagnosis, therefore controlling SSB consumption may potentially improve pulmonary health risk in the US pediatric population.
Luyu Xie; Folefac Atem; Andrew Gelfand; George Delclos; Sarah E. Messiah. Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population. Journal of Asthma 2021, 1 -8.
AMA StyleLuyu Xie, Folefac Atem, Andrew Gelfand, George Delclos, Sarah E. Messiah. Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population. Journal of Asthma. 2021; ():1-8.
Chicago/Turabian StyleLuyu Xie; Folefac Atem; Andrew Gelfand; George Delclos; Sarah E. Messiah. 2021. "Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population." Journal of Asthma , no. : 1-8.
Introduction The science of telemedicine has shown great advances over the past decade. However, the field needs to better understand if a change in care delivery from in-person to telehealth as a result of the COVID-19 pandemic will yield durable patient engagement and health outcomes for patients with obesity. The objective of this study was to examine the association of mode of healthcare utilization (telehealth versus in-person) and sociodemographic factors among patients with obesity during the COVID-19 pandemic. Methods A retrospective medical chart review identified patients with obesity from a university outpatient obesity medicine clinic and a community bariatric surgery practice. Patients completed an online survey (1 June 2020–24 September 2020) to assess changes in healthcare utilization modality during subsequent changes in infection rates in the geographic area. Logistic regression analysis examined the association of mode of healthcare utilization and key sociodemographic characteristics. Results A total of 583 patients (87% female, mean age 51.2 years (standard deviation 13.0), mean body mass index 40.2 (standard deviation 6.7), 49.2% non-Hispanic white, 28.7% non-Hispanic black, 16.4% Hispanic, 7% other ethnicity, 33.1% completed bariatric surgery) were included. Adjusted logistic regression models showed older age was inversely associated with telehealth use (adjusted odds ratio = 0.58, 95% confidence interval 0.34–0.98) and non-Hispanic black were more likely to use telehealth compared to non-Hispanic white (adjusted odds ratio = 1.72, 95% confidence interval 1.05–2.81). Conclusions The COVID-19 pandemic is impacting access to healthcare among patients with obesity. Telehealth is an emerging modality that can maintain healthcare access during the pandemic, but utilization varies by age and ethnicity in this high-risk population.
Jaime P Almandoz; Luyu Xie; Jeffrey N Schellinger; M Sunil Mathew; Khary Edwards; Ashley Ofori; Sachin Kukreja; Benjamin Schneider; Sarah E Messiah. Telehealth utilization among multi-ethnic patients with obesity during the COVID-19 pandemic. Journal of Telemedicine and Telecare 2021, 1 .
AMA StyleJaime P Almandoz, Luyu Xie, Jeffrey N Schellinger, M Sunil Mathew, Khary Edwards, Ashley Ofori, Sachin Kukreja, Benjamin Schneider, Sarah E Messiah. Telehealth utilization among multi-ethnic patients with obesity during the COVID-19 pandemic. Journal of Telemedicine and Telecare. 2021; ():1.
Chicago/Turabian StyleJaime P Almandoz; Luyu Xie; Jeffrey N Schellinger; M Sunil Mathew; Khary Edwards; Ashley Ofori; Sachin Kukreja; Benjamin Schneider; Sarah E Messiah. 2021. "Telehealth utilization among multi-ethnic patients with obesity during the COVID-19 pandemic." Journal of Telemedicine and Telecare , no. : 1.
Millions of Americans qualify for metabolic and bariatric surgery (MBS) based on the proportion of the population with severe obesity. Simultaneously, the use of electronic nicotine/non-nicotine delivery systems (ENDS) has become epidemic. We conducted a timely systematic review to examine the impact of tobacco and ENDS use on post-operative health outcomes among MBS patients. PRISMA guidelines were used as the search framework. Keyword combinations of either “smoking,” “tobacco,” “e-cigarette,” “vaping,” or “ENDS” and “bariatric surgery,” “RYGB,” or “sleeve gastrectomy” were used as search terms in PUBMED, Science Direct, and EMBASE. Studies published in English between January 1990 and June 2020 were screened. From the 3251 articles found, a total of 48 articles were included in the review. No articles described a relationship between ENDS and post-operative health outcomes in MBS patients. Seven studies reported smokers had greater post-MBS weight loss, six studies suggested no relationship between smoking and post-MBS weight loss, and one study reported smoking cessation pre-MBS was related to post-MBS weight gain. Perioperative use of tobacco is positively associated with several post-surgery complications and mortality in MBS patients. Combustible tobacco use among MBS patients is significantly related to higher mortality risk and complication rates, but not weight loss. No data currently is available on the impact of ENDS use in these patients. With ENDS use at epidemic levels, it is imperative to determine any potential health effects among patients with severe obesity, and who complete MBS.
Nimisha Srikanth; Luyu Xie; Elisa Morales-Marroquin; Ashley Ofori; Nestor de la Cruz-Muñoz; Sarah E. Messiah. Intersection of smoking, e-cigarette use, obesity, and metabolic and bariatric surgery: a systematic review of the current state of evidence. Journal of Addictive Diseases 2021, 1 -19.
AMA StyleNimisha Srikanth, Luyu Xie, Elisa Morales-Marroquin, Ashley Ofori, Nestor de la Cruz-Muñoz, Sarah E. Messiah. Intersection of smoking, e-cigarette use, obesity, and metabolic and bariatric surgery: a systematic review of the current state of evidence. Journal of Addictive Diseases. 2021; ():1-19.
Chicago/Turabian StyleNimisha Srikanth; Luyu Xie; Elisa Morales-Marroquin; Ashley Ofori; Nestor de la Cruz-Muñoz; Sarah E. Messiah. 2021. "Intersection of smoking, e-cigarette use, obesity, and metabolic and bariatric surgery: a systematic review of the current state of evidence." Journal of Addictive Diseases , no. : 1-19.
Studies have shown the negative impact of COVID‐19 lockdown orders on mental health and substance use in the general population. The aim of this study was to examine the impact of the COVID‐19 pandemic onsubstance use, mental health and weight‐related behaviors in a sample of adults with obesity after lockdown orders were lifted (June‐September 2020). A retrospective medical chart review identified patients with obesity from one university‐based obesity medicine clinic, and two metabolic and bariatric surgery (MBS) practices. Patients who completed an online survey from June 1, 2020 to September 30, 2020 were included. The primary outcome measure was substance use (various drugs, alcohol, tobacco). Substance use and mental health survey questions were based on standardized, validated instruments. A total of 589 patients (83.3% female, mean age 53.6 years [SD 12.8], mean BMI 35.4 [SD 9.1], 54.5% Non‐Hispanic white, 22.3% post‐MBS) were included. Seventeen patients (2.9%) tested positive for SARS‐CoV‐2 and 13.5% reported symptoms. Nearly half (48.4%) of the sample reported recreational substance use and 9.8% reported increased use since the start of the pandemic. There was substantial drug use reported (24.3% opioids, 9.5% sedative/tranquilizers, 3.6% marijuana, and 1% stimulants). Patients who reported stockpiling food more (adjusted Odds Ratio [aOR] 1.50, 95% CI 1.03‐2.18), healthy eating more challenging (aOR 1.47, 95% CI 1.01‐2.16), difficulty falling asleep (aOR 1.64, 95% CI 1.14‐2.34), and anxiety (aOR 1.47, 95% CI 1.01‐2.14) were more likely to report substance use versus non‐users. Results here show that the COVID‐19 pandemic is having a deleterious impact on substance use, mental health and weight‐related health behaviors in people with obesity regardless of infection status.
Jaime P. Almandoz; Luyu Xie; Jeffrey N. Schellinger; M. Sunil Mathew; Nora Bismar; Ashley Ofori; Sachin Kukreja; Benjamin Schneider; Denise Vidot; Sarah E. Messiah. Substance use, mental health and weight‐related behaviours during the COVID ‐19 pandemic in people with obesity. Clinical Obesity 2021, 11, e12440 .
AMA StyleJaime P. Almandoz, Luyu Xie, Jeffrey N. Schellinger, M. Sunil Mathew, Nora Bismar, Ashley Ofori, Sachin Kukreja, Benjamin Schneider, Denise Vidot, Sarah E. Messiah. Substance use, mental health and weight‐related behaviours during the COVID ‐19 pandemic in people with obesity. Clinical Obesity. 2021; 11 (2):e12440.
Chicago/Turabian StyleJaime P. Almandoz; Luyu Xie; Jeffrey N. Schellinger; M. Sunil Mathew; Nora Bismar; Ashley Ofori; Sachin Kukreja; Benjamin Schneider; Denise Vidot; Sarah E. Messiah. 2021. "Substance use, mental health and weight‐related behaviours during the COVID ‐19 pandemic in people with obesity." Clinical Obesity 11, no. 2: e12440.
Introduction Medicaid expansion increased access to care, but longitudinal patterns of contraception use after the Medicaid expansion have not been described. Methods We evaluated the effects of Medicaid expansion on the amount and type of contraceptive prescriptions using the Medicaid State Utilization Dataset. Results Overall long-acting reversible contraception (LARC) use increased in both expansion and non-expansion states. In a difference-in-differences analysis, states that expanded Medicaid had no appreciable increase in per-capita prescription rates of LARC (p = 0.26) or short-acting hormonal contraception (p = 0.09) when compared to nonexpansion states. Discussion The Medicaid expansion was not associated with a change in per-capita LARC or short-acting hormonal contraception use.
Andrew Sumarsono; Matthew W Segar; Luyu Xie; Folefac Atem; Sarah E Messiah; Jenny Kr Francis; Neil Keshvani. Medicaid expansion and provision of prescription contraception to Medicaid beneficiaries. Contraception 2020, 103, 199 -202.
AMA StyleAndrew Sumarsono, Matthew W Segar, Luyu Xie, Folefac Atem, Sarah E Messiah, Jenny Kr Francis, Neil Keshvani. Medicaid expansion and provision of prescription contraception to Medicaid beneficiaries. Contraception. 2020; 103 (3):199-202.
Chicago/Turabian StyleAndrew Sumarsono; Matthew W Segar; Luyu Xie; Folefac Atem; Sarah E Messiah; Jenny Kr Francis; Neil Keshvani. 2020. "Medicaid expansion and provision of prescription contraception to Medicaid beneficiaries." Contraception 103, no. 3: 199-202.
Luyu Xie; Devika R. Rao; Melissa B. Harrell; Denise C. Vidot; Andrew Gelfand; Kimberle Sterling; Sarah E. Messiah. Ethnic disparities in the e‐cigarette use epidemic and childhood asthma in the US. Pediatric Pulmonology 2020, 55, 2498 -2500.
AMA StyleLuyu Xie, Devika R. Rao, Melissa B. Harrell, Denise C. Vidot, Andrew Gelfand, Kimberle Sterling, Sarah E. Messiah. Ethnic disparities in the e‐cigarette use epidemic and childhood asthma in the US. Pediatric Pulmonology. 2020; 55 (10):2498-2500.
Chicago/Turabian StyleLuyu Xie; Devika R. Rao; Melissa B. Harrell; Denise C. Vidot; Andrew Gelfand; Kimberle Sterling; Sarah E. Messiah. 2020. "Ethnic disparities in the e‐cigarette use epidemic and childhood asthma in the US." Pediatric Pulmonology 55, no. 10: 2498-2500.
How the impact of the COVID‐19 stay‐at‐home orders is influencing physical, mental and financial health among vulnerable populations, including those with obesity is unknown. The aim of the current study was to explore the health implications of COVID‐19 among a sample of adults with obesity. A retrospective medical chart review identified patients with obesity from an obesity medicine clinic and a bariatric surgery (MBS) practice. Patients completed an online survey from April 15, 2020 to May 31, 2020 to assess COVID‐19 status and health behaviours during stay‐at‐home orders. Logistic regression models examined the impact of these orders on anxiety and depression by ethnic group. A total of 123 patients (87% female, mean age 51.2 years [SD 13.0]), mean BMI 40.2 [SD 6.7], 49.2% non‐Hispanic white (NHW), 28.7% non‐Hispanic black, 16.4% Hispanic, 7% other ethnicity and 33.1% completed MBS were included. Two patients tested positive for severe acute respiratory syndrome coronavirus 2 and 14.6% reported symptoms. Then, 72.8% reported increased anxiety and 83.6% increased depression since stay‐at‐home orders were initiated. Also 69.6% reported more difficultly in achieving weight loss goals, less exercise time (47.9%) and intensity (55.8%), increased stockpiling of food (49.6%) and stress eating (61.2%). Hispanics were less likely to report anxiety vs NHWs (adjusted odds ratios 0.16; 95% CI, 0.05‐0.49; P = .009). Results here showed the COVID‐19 pandemic is having a significant impact on patients with obesity regardless of infection status. These results can inform clinicians and healthcare professionals about effective strategies to minimize COVID‐19 negative outcomes for this vulnerable population now and in post‐COVID‐19 recovery efforts.
Jaime Almandoz; Luyu Xie; Jeffrey N. Schellinger; Matthew Sunil Mathew; Chellse Gazda; Ashley Ofori; Sachin Kukreja; Sarah E. Messiah. Impact of COVID ‐19 stay‐at‐home orders on weight ‐ related behaviours among patients with obesity. Clinical Obesity 2020, 10, e12386 .
AMA StyleJaime Almandoz, Luyu Xie, Jeffrey N. Schellinger, Matthew Sunil Mathew, Chellse Gazda, Ashley Ofori, Sachin Kukreja, Sarah E. Messiah. Impact of COVID ‐19 stay‐at‐home orders on weight ‐ related behaviours among patients with obesity. Clinical Obesity. 2020; 10 (5):e12386.
Chicago/Turabian StyleJaime Almandoz; Luyu Xie; Jeffrey N. Schellinger; Matthew Sunil Mathew; Chellse Gazda; Ashley Ofori; Sachin Kukreja; Sarah E. Messiah. 2020. "Impact of COVID ‐19 stay‐at‐home orders on weight ‐ related behaviours among patients with obesity." Clinical Obesity 10, no. 5: e12386.
The prevalence of asthma in US children with various developmental disabilities and delays is unclear, including how estimates vary by ethnic group. To report asthma prevalence estimates by various disability categories and developmental delays in a diverse sample of the US pediatric population. This population-based cross-sectional study encompassed a total of 71 811 families with children or adolescents aged 0 to 17 years (hereinafter referred to as children) who participated in the 2016 and 2017 National Survey of Children's Health. Data were collected from June 10, 2016, to February 10, 2017, for the 2016 survey and from August 10, 2017, to February 10, 2018, for the 2017 survey. Data were analyzed from September 20, 2019, to April 5, 2020. Developmental disability, including attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, seizure, intellectual and/or learning disability, and vision, hearing, and/or speech delay. Delay was defined as not meeting growth milestones with unknown cause. Weighted asthma prevalence estimates and 95% CIs were generated for children with and without disabilities. A total of 71 811 participants (mean [SE] age, 8.6 [0.1] years; 36 800 boys [51.1%; 95% CI, 50.2%-52.0%]; 50 219 non-Hispanic white [51.4%; 95% CI, 50.6%-52.3%]) were included in our final analytical sample, of whom 5687 (7.9%; 95% CI, 7.5%-8.4%) had asthma and 11 426 (15.3%; 95% CI, 14.7%-16.0%) had at least 1 disability. Overall asthma prevalence estimates were 10 percentage points higher in children with a disability (16.1%; 95% CI, 14.3%-17.8%) vs children without a disability (6.5%; 95% CI, 6.0%-6.9%). The odds of asthma were significantly higher in children with a disability (odds ratio [OR], 2.77; 95% CI, 2.39-3.21) or delay (OR, 2.22; 95% CI, 1.78-2.77) vs typically growing children. Adjusted models remained significant for all disability categories (overall adjusted OR, 2.21; 95% CI, 1.87-2.62). Subgroup analyses showed ethnic minorities had a higher prevalence of concurrent asthma and developmental disabilities vs non-Hispanic whites (19.8% [95% CI, 16.6%-23.0%] vs 12.6% [95% CI, 11.1%-14.0%]; P < .001). These results suggest that US children with various developmental disabilities or delay may have higher odds for developing asthma vs their typically developing peers. These findings support asthma screening in pediatric health care settings among patients with developmental disabilities and delays, particularly among those from ethnic minority backgrounds. In addition, very young children with asthma should be screened for disabilities and delays, because temporality cannot be determined by the current data source and analytical approach.
Luyu Xie; Andrew Gelfand; George L. Delclos; Folefac D. Atem; Harold W. Kohl; Sarah Messiah. Estimated Prevalence of Asthma in US Children With Developmental Disabilities. JAMA Network Open 2020, 3, e207728 .
AMA StyleLuyu Xie, Andrew Gelfand, George L. Delclos, Folefac D. Atem, Harold W. Kohl, Sarah Messiah. Estimated Prevalence of Asthma in US Children With Developmental Disabilities. JAMA Network Open. 2020; 3 (6):e207728.
Chicago/Turabian StyleLuyu Xie; Andrew Gelfand; George L. Delclos; Folefac D. Atem; Harold W. Kohl; Sarah Messiah. 2020. "Estimated Prevalence of Asthma in US Children With Developmental Disabilities." JAMA Network Open 3, no. 6: e207728.
Objectives. We sought to update the prevalence estimates of parent-reported asthma diagnosis by Environmental Tobacco Smoke (ETS) exposure in the United States (US) pediatric population. Methods. This cross-sectional study included 71,811 families with children who participated in the 2016-2017 National Survey of Children’s Health (NSCH). Weighted asthma prevalence estimates were calculated for ETS-exposed and non-exposed children. Chi-square analysis compared asthma prevalence between the two exposure groups and logistic regression analysis generated adjusted odds ratios (aORs) of asthma diagnosis by ETS exposure by sex, race/ethnicity, and household education and income level. Results. Asthma prevalence estimates were significantly higher in ETS-exposed versus non-exposed children (10.7% vs. 7.8%, p < 0.001). Children with a smoker in the house are 30% more likely to have an asthma diagnosis versus children with no smokers in the house (aOR 1.29, 95% Confidence Interval [CI] 1.09-1.52). Significant predictors for ETS exposure included < high school education and lower family income. Conversely, non-Hispanic black and Hispanic black children were less likely to have ETS exposure versus non-Hispanic white children. Conclusions. ETS exposure is a significant risk factor for asthma in the US pediatric population. Smoking cessation initiatives targeting non-Hispanic white parents from lower socioeconomic may improve children’s chronic pulmonary health risk.
Luyu Xie; Folefac Atem; Andrew Gelfand; Cici Bauer; Sarah E. Messiah. United States prevalence of pediatric asthma by environmental tobacco smoke exposure, 2016–2017. Journal of Asthma 2020, 58, 430 -437.
AMA StyleLuyu Xie, Folefac Atem, Andrew Gelfand, Cici Bauer, Sarah E. Messiah. United States prevalence of pediatric asthma by environmental tobacco smoke exposure, 2016–2017. Journal of Asthma. 2020; 58 (4):430-437.
Chicago/Turabian StyleLuyu Xie; Folefac Atem; Andrew Gelfand; Cici Bauer; Sarah E. Messiah. 2020. "United States prevalence of pediatric asthma by environmental tobacco smoke exposure, 2016–2017." Journal of Asthma 58, no. 4: 430-437.