Written Opinion Editorial 

Use the synthesis of the literature matrix dissection assignment as support for an opinion and a call to action about an environmental health issue or problem. Opinion editorials typically appear opposite the editorial page in a newspaper and voice a perspective on an issue of importance that is clear, compelling, and focused and urges the public to take action. It is important for public health graduate professionals to be able to synthesize the scientific literature and take leadership roles in communicating salient environmental health issues to the lay public. As preparation, U will read the short article from Harvard University: Harvard, Kennedy School, Shorenstein Center on Media, Politics and Public Policy (2013). How to write an op-ed or column:  

https://journalistsresource.org/tip-sheets/writing/how-to-write-an-op-ed-or-column/

MATRIXASSIGNMENT TEMPLATE

Name:

Descriptive statement of the Environmental Health issue or problem and a specific population that was researched in the literature review dissection and synthesis using the matrix method: Asthma is a challenging health complication that is brought about by environmental factors and reduces the quality of life of individuals experiencing asthmatic attacks than those who live free from these asthmatic attacks. Everyday many people die from asthma and with proper treatment and management, these deaths in the Urban and Rural population can be avoidable to a great extent.

Article

References

Year of publication

Study Design and Aim(s)

Recruitment

and final number enrolled.

Major results

Limitations

Implications for Population Health

(List articles from oldest to newest to see improvements/consistencies over time with a glance of the matrix)

([A]Study Design: List: Cohort; case control; randomized controlled trial; quazi-experimental; cross sectional; ecological.

[B] Aim(s): Major aim(s) pertaining directly to the EHS you are researching)

Recruitment

process and final number enrolled)

(Major statistical results pertaining to primary aims)

(Major sources of potential epidemiological bias)

(Major findings pertaining directly to the EHS issue you are researching; can include professional Public Health practice, policy, and research)

(1) Akinbami, L. J.

Moorman, J. E.,

Simon, A. E., and Schoendorf, K. C.

2014

A cross-sectional study that assesses racial disparity in childhood asthma which has impacted different people.

Weighted log-linear regression was conducted between 2001 and 2010 through visiting hospital visits. The trends were then calculated. The changes in racial disparity in terms of asthma were assessed using Joinpoint.

Asthma disparity prevalence between black and white children enhanced between 2001 and 2010. The black children were twice as likely to become asthmatic.

Asthma prevalence is based on a proxy report. The researchers do not put into consideration accounting for the differences as a result of asthma severity.

Analysis of at-risk rate to get racial disparity in relation to asthmatic attack demonstrates that amongst the many children with asthmatic attacks, there is no disparity for asthmatic attack prevalence. Further, significant progress has been made to reduce the disparities through a visit to the emergency department and an increased rate of hospitalization. Therefore, public health officials should heighten the sensitization exercise to broaden hospital visitations.

(2) Sheikh, A., Steiner, M. F., Cezar, G., Bansal, N., Fischbacher, C., Simpson, C. R., … and Bhopal, R.

2016

A Poisson regression model employing strong variance calculated the age-adjusted rates. Also made a connection to create a link between the encrypted community Health Index and census number to create the cohort.

A national cohort of 4.62 million people was studied.

Considerable ethic variations when it comes to hospitalization and deaths. Compared to the reference group, Pakistani males recorded the highest age-adjusted rates where the Chinese have the best outcomes while Pakistanis have the worst outcome.

First, the data estimates were derived from a pool of a limited number of current studies, which were only linked to three broad ethnic groups. The study failed to take into consideration the likely sex-related differences in outcomes within the different ethnic groups. The study also focused on the entire population.

The health implication of the study demonstrates that there are considerable ethnic variations when it comes to asthma deaths and readmissions. The variations are likely to be a result of cultural factors, health-seeking behaviors, and differences in the quality of primary care provision. Public health officials should be concerned to understand the reasons for the striking differences in health outcomes.

(3) Asher, I., Haahtela, T., Selroos, O., Ellwood, P., Ellwood, E., and Global Asthma Network Study Group

2017

A cross-sectional survey was done between 2013 April and July 2014.

276 center principal investigators were used in 120 countries.

Investigators in 112 countries which represents 93.3%, answered the question. It emerged that 23.2% of the countries reported having a national asthma strategy for children, 21.4% for adults, and 19.6% of the countries had a plan for both children and adults.

A major limitation of the study is the fact that it lacks a systematic appraisal of the degree of asthma strategies in asthma management.

A better approach to handling asthma can be achieved if many countries came together to handle the global burden by adopting the asthma strategy. Also, it emerged that many countries do not have a national asthma strategy making it more difficult to handle the complications that come from asthma-related conditions. Therefore, there is a need for the health authorities in different countries to develop a national asthma strategy with a national scope to improve early detection and improve management hence reducing costs involved.

(4) Park, H. J., Byun, M. K., Kim, H. J., Ahn, C. M., Rhee, C. K., Kim, K., … and Yoo, K. H.

2018

A cross-sectional observation study is employing data in the national medical insurance review system used by the Health Insurance Review Assessment.

The study included participants above 15 years with asthma diagnosis and complications from July 2013 to June 2014. A total of 729,343 were examined, and 68% classified as regular visitors.

Frequent visitors showed a lower risk of asthma that required general ward admission at a rate of 68.1%, which is an indication that those who have regular visits to the hospital had protective effects against asthma.

The study being a cross-section and not a cohort study, it is difficult to conclude that regular visits directly reduce asthma aggravations—inability to analyze potential variables affecting the frequency of visits. Also, the study employed an operational definition of asthma exacerbation that may influence the outcome.

Asthma is a chronic disease that needs consistent care and long term follow-up. Therefore, public healthcare officials have a duty to educate the public regarding asthma action plans to attend regular follow-ups to achieve a better prognosis of the disease. To improve adherence and compliance, it is necessary to have regular visitors that encourage attention in care provision.

(5) Patel, O., Syamlal, G., Wood, J., Dodd, K. E., & Mazurek, J. M.

2018

Cross-sectional analysis to examine asthma mortality amongst persons aged 15-64 years. The deaths arising from asthma were identified using the international classification of diseases. Time trends were analyzed through a linear regression model.

About 11-21% of asthma mortalities arise from occupational exposures.

Adults aged between 15 and 64 in the U.S experienced 33,307 deaths between 1999 and 2016. Out of this, between 3, 600 and 6,900 were attributed to workplace exposure, which could be prevented.

Challenge in validating asthma and asthmatics diagnosis. No available information to confirm that workforce exposure triggered the asthmatic attack. No available work history to assess employment changes.

The increased asthma mortality rates amongst males and females in some industries outline the need for optimal management of asthma and the prevention of workplace exposure.

(6) Serebrisky, D., and Wiznia, A.

2019

Cross-sectional analysis that determines the extent of mortality and morbidity of children between 6 and 14 years.

The study entails over 700,000 children from 56 countries.

There is a significant increase in the global prevalence, mortality, and morbidity related to asthma in children over the past 40 years. Despite the widespread cases of asthma, there are cases of underdiagnosis and undertreatment of asthma.

The research is not encompassing and cannot be used to describe the global scope of asthma in children.

Due to the widespread cases of asthma in the world, there is a necessity for different governments to commit to research, intervention, and monitoring to reduce the burden of asthma in the world.

(7) Stefan Ebmeier, Darmiga Thayabaran, Irene Braithwaite, Clément Bénamara, Mark Weatherall, and Richard Beasley

2020

A cross-sectional study that examines data from country-specific asthma mortality rates from the WHO database for 46 countries.

The analysis included 46 countries, out of which 36 were high incomes while 10 were middle-income countries.

The rate of death has not significantly changed for a decade. However, low-income countries demonstrated higher trends compared to high-income asthma mortality.

The data trends observed in the study are limited to the countries included hence brings forth a rather inaccurate global trend in asthma mortalities.

The study demonstrates that global asthma mortality rates have not changed over the past decade. Despite a reduction in the number of deaths caused by asthma in some countries, the average mortality rates have not reduced since 2006. Therefore, the chances are high that the progress made over the past few decades might have stopped.

Written Narrative of Literature Synthesis: A one to two paragraph synthesis of the major collective findings that pertain directly to the Environmental Health problem / issue researched through the literature review dissection and synthesis. It is recommended to read every column heading vertically from top to bottom and write a brief summary of the findings seen across the literature over time from each heading category including, types of study designs utilized, study populations and recruitment strategies, major results, major epidemiological limitations, and implications for future public health practice, research, and policy. The existing literature on asthma and related deaths provides evidence that environmental factors can have a significant effect on the health of individuals. The number of deaths realized as a result of asthma has been on the decline due to the different measures that are taken by governments. However, it is evident that not all governments are involved in measures to mitigate asthma deaths. Therefore, there is a need for the different governments to come up with strategies to intervene and improve the health status of their citizens, putting into consideration the preventive measures. Public health officials should recognize some of the workplace exposures that heighten the chances of getting chronic asthma and deeply engage in advising and regulating the workplace environment to help reduce the risks associated with such exposures. Also, it is important for the healthcare providers to advise the public on the different measures that can be taken to manage chronic asthma to avoid the high rate of fatalities that are witnessed as a result of the condition. This way, the world will be able to collaboratively deal with asthma. The limitation of this literature review is the fact that most of the studies are cross-sectional and this hinders the effectiveness and scope of the research as there is a limited way to prove a concrete relationship between asthma and the negative health outcomes. The limitation in the scope of the literature is because there are no randomized controlled trials or cohort studies that can authoritatively demonstrate a causal relationship between the different variables. The research was completed using PubMed and the keywords “reducing asthma deaths” were used. Given the limitation derived from the choice of research method, there is a need to conduct further studies using random controlled trials or cohorts to ascertain the relationship that exists between environment, asthma, and mortality.

References

Akinbami, L. J., Moorman, J. E., Simon, A. E., & Schoendorf, K. C. (2014). Trends in racial disparities for asthma outcomes among children 0 to 17 years, 2001-2010. Journal of Allergy and Clinical Immunology, 134(3), 547-553.

Asher, I., Haahtela, T., Selroos, O., Ellwood, P., Ellwood, E., & Global Asthma Network Study Group. (2017). Global Asthma Network survey suggests more national asthma strategies could reduce the burden of asthma. Allergologia et immunopathologic, 45(2), 105-114.

Kearney, G. D., Wooten, W., Mohan, A., Christopher Carter, J., Jones, K., Blount, T., & O’Brien, K. (2020). Asthma deaths in North Carolina: 1999–2016. Journal of Asthma, 57(5), 478-486.

Park, H. J., Byun, M. K., Kim, H. J., Ahn, C. M., Rhee, C. K., Kim, K., … & Yoo, K. H. (2018). Regular follow-up visits reduce the risk for asthma exacerbation requiring admission in Korean adults with asthma. Allergy, Asthma & Clinical Immunology, 14(1), 1-7.

Patel, O., Syamlal, G., Wood, J., Dodd, K. E., & Mazurek, J. M. (2018). Asthma mortality among persons aged 15–64 years, by industry and occupation—the United States, 1999–2016. Morbidity and Mortality Weekly Report, 67(2), 60.

Serebrisky, D., & Wiznia, A. (2019). Pediatric asthma: a global epidemic. Annals of Global health, 85(1).

Sheikh, A., Steiner, M. F., Cezar, G., Bansal, N., Fischbacher, C., Simpson, C. R., … & Bhopal, R. (2016). Ethnic variations in asthma hospital admission, readmission, and death: a retrospective, national cohort study of 4.62 million people in Scotland. BMC medicine, 14(1), 1-9.