smokey fire landscape

Wildfire smoke pollution and asthma-related health care utilization among children

About

As wildfires continue to grow in size and frequency across the United States, millions of people are experiencing more days with unhealthy air. As these fires burn, they produce massive smoke plumes that can drift hundreds or even thousands of miles, raising air pollution levels far from the fire itself. This smoke contains fine particulate matter known as PM₂.₅ or particles 2.5 micrometers or smaller that are capable of reaching the deepest parts of the lungs, where they can trigger inflammation and airway irritation. Particulate matter from wildfires may be more irritating and harmful than everyday air pollution (Aguilera et al., 2021). For people with asthma, exposure to wildfire smoke can make symptoms worse or even lead to severe asthma attacks.

This project looks closely at how wildfire-related PM₂.₅ affects people, particularly children, with asthma. We will examine whether wildfire smoke leads to increased use of inhalers and other fast-acting asthma medications, and whether it results in more visits to clinics, urgent care centers, or hospitals for asthma symptoms. Our focus on children reflects existing research that identifies this group as particularly vulnerable to the health impacts of wildfire smoke.

Approach

Using claims data from a large health insurance provider, we are building a dataset of daily, Census tract utilization rates for asthma-related outcomes and linking it with data on wildfire-attributed PM₂.₅. Our sample includes healthcare claims for more than 745,000 children over an eight-year period. Unlike previous studies that focus on emergency department visits, we capture all healthcare interactions that these children make – emergency departments visits, outpatient visits, inpatient hospital stays, and telehealth visits. 

Importantly, we also have detailed information on short-acting inhalers and other asthma related prescription fills for these children. This comprehensive claims data, combined with the longer study period and the wide geographic range, allows us to provide a more complete understanding of how wildfire smoke affects asthma-related healthcare use.

Partners

This project is a collaboration with Jeff Romine (Carelon Research), Daniel Cullen (Elevance Health Public Policy Institute) and Corey White (Amazon and Monash University).