Epidemiology and Economics of California Wildfire Smoke and Allergic Disease in Children
Grantees: Anjali Dixit, Postdoctoral Scholar, Anesthesiology, Perioperative and Pain
Laurence Baker, Professor of Health Policy, Department of Health Policy; Freeman Spogli Institute and Stanford University School of Medicine
Allergic disease, including both asthma and atopic dermatitis, is a highly prevalent, burdensome, and costly problem for children and their families in the United States. Children with asthma undergoing surgery are at increased risk of life-threatening respiratory complications associated with exposure to general anesthesia. Racial and ethnic disparities in the prevalence and treatment of allergic disease are well- documented. As the climate crisis in California continues, with more frequent and destructive annual wildfires, existing racial disparities in pediatric allergic disease may be exacerbated. We therefore aim to investigate the association between wildfire smoke and pediatric allergic disease, focusing on asthma and atopic dermatitis, through a lens of 1) racial equity, 2) economic burden, and 3) safety of surgical care. We will address these associations via a novel linkage of Medi-Cal data – which is uniquely suited to our research questions given its breadth and inclusion of a large proportion of children in California, many of whom are Black, Hispanic, or Asian – with both a national hazard mapping system to detect wildfire smoke plumes and the Environmental Protection Agency’s Air Quality dataset. We will draw from our inter- disciplinary expertise in methodology and clinical subject matter and will apply sophisticated epidemiologic and econometric approaches to reduce confounding and isolate causal effects. Our work will have important impacts on clinical care and health policy and is particularly salient given the ongoing climate crisis in California and its exacerbation of known inequities in child health.