17% vs 5%
urgent health service use fell more than three times as much in the high-intensity group
Exact: 17.0% vs 4.6%
Urgent health services use dropped 17% in the high-intensity group versus 4.6% in the low-intensity group
In a randomised trial of 274 low-income households with a child aged 4-12 with asthma, community health workers delivered either seven home visits with a full set of resources or a single visit with limited resources over a year. The proportion reporting urgent asthma-related health service use in the past two months fell by 17.0% in the high-intensity group, compared with a 4.6% fall in the low-intensity group, a difference the study reports as statistically significant.
For housing and health programme designers, this points to a dose-response pattern: more intensive, in-home environmental and behavioural support from community health workers, aimed at reducing indoor asthma triggers, is likely to reduce urgent care use more than a lighter-touch visit. This is relevant to anyone deciding how to allocate home-visit resources for low-income households with asthmatic children.
The evidence is well supported, drawn from a randomised controlled trial with a significant group difference (P=.026). It applies specifically to low-income households with a child aged 4 to 12 with asthma, followed over one year and to a comparison between two defined visit intensities rather than to home visiting in general. A related outcome, symptom days, did not reach significance, so not every measure moved the same way.
Housing
The absolute change in the proportion with urgent use in the past 2 months was 17.0% in the high-intensity group and 4.6% in the low-intensity group, adjusted for baseline differences and within-group correlations, using the Stata PREDICT function.
Related studysheets
>£50,000/person
economic cost per person of urban exposure failures
Non-compliance with recommended urban exposure levels translates to economic losses of over £50,000 per person in Bradford.
Mueller N et al., 2018, Environment international
>300 days
life expectancy lost per person due to urban exposure failures
Non-compliance with recommended urban exposure levels is estimated to cost Bradford residents over 300 days of life expectancy each.
Mueller N et al., 2018, Environment international
375 deaths/year
annual premature deaths attributed to unhealthy urban exposures
An estimated 375 premature deaths per year in Bradford are attributable to non-compliance with recommended exposure levels for physical activity, air pollution, noise and green space.
Mueller N et al., 2018, Environment international
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