Chronic Disease Emergency Room Visits
The rate at which St. Louis residents visit emergency rooms for treatment of a chronic disease per 1,000 residents
Black residents are more than three times as likely to visit an emergency room for suffering related to chronic disease as white residents.
A score of 100 represents racial equity, meaning there are no racial disparities in outcomes. The lower the Equity Score, the greater the disparity.
For Chronic Disease Emergency Room Visits, a score of 100 — a score reflecting racial equity — would mean black and white residents are equally likely to visit the emergency room for treatment of a chronic disease. It is important to note that for this indicator, equity is not our only goal; we also want to improve outcomes for all.
What does this indicator measure?
Chronic Disease Emergency Room Visits measures the rate at which St. Louis residents visit emergency rooms for treatment of a chronic disease per 1,000 residents. Chronic disease is defined as any disease or condition that lasts three months or longer that generally cannot be prevented by a vaccine or cured by medicine. In 2015, there were 23,284 emergency room visits for treatment of a chronic disease, at a rate of 73 emergency room visits per 1,000 residents.
Chronic Disease Emergency Room Visits analysis
Emergency room visits for chronic disease per 1,000 residents in St. Louis City.
|All||Black||White||Disparity Ratio||Equity Score|
|Emergency room visits||23,284||17,248||5,256||-||-|
|Emergency room visits per 1,000 residents||73.1||114.8||33.0||3.479 to 1||31|
Data Source: Missouri Department of Health and Social Services, Chronic Disease Emergency Room MICA , 2015.
Data Note: Chronic diseases include alcohol and substance-related mental disorders, asthma, atherosclerosis, cerebrovascular disease, chronic obstructive pulmonary disease and bronchiectasis, chronic renal failure, diabetes, diseases of the heart, epilepsy, hypertension, liver disease, neoplasms - malignant (cancer), non-traumatic joint disorders, other cardiovascular/circulatory conditions, and sickle cell anemia. Rates are per year per 1,000 population and are age-adjusted to the U.S. 2000 standard population. The age-adjusted rates are rates that would have existed if the population under study had the same age distribution as the "standard" population. Age adjusting rates is a way to make fairer comparisons between groups with different age distributions.
What does this analysis mean?
Black residents are more than three times as likely as white residents to visit an emergency room for chronic disease (115 per 1,000 black residents, compared to 33 per 1,000 white residents). If chronic disease emergency room visits were equitable, black residents would have visited emergency rooms 12,291 fewer times in 2015 to treat chronic disease.
The most common chronic diseases that cause black residents to visit the emergency room include asthma (22% of all visits), heart diseases (21%), and non-traumatic joint disorders (18%). The most common chronic diseases that cause white residents to visit the emergency room include heart disease (26% of all visits), alcohol and substance-related mental disorders (22%), and non-traumatic joint disorders (13%). Black residents are more than 9 times as likely as white residents to visit an emergency room for asthma, more than 6 times as likely for hypertension, and almost 5 times as likely for diabetes.
Why do Chronic Disease Emergency Room Visits matter?
Emergency room visits for chronic disease represent both our best estimates of chronic disease rates in the population, and the ability of people to manage their chronic disease. Chronic diseases, according to the Centers for Disease Control and Prevention, "are the most common, costly, and preventable of all health problems." Many chronic diseases are linked with quality-of-life issues, including lack of walkable neighborhoods, limited access to fresh food, and high levels of stress.
Emergency rooms are meant to serve as the healthcare of last resort, yet the data show that many residents are using them to treat chronic diseases because they lack access to more regular and preventive care. The Ferguson Commission highlighted that emergency room use is tied to people having to delay or forgo needed care because of a lack of health insurance.
Which Calls to Action from the Ferguson Commission report are linked with this indicator?
The Ferguson Commission’s calls to action intended to reduce reliance upon emergency rooms as sources of primary care include:
Questions for further investigation
- Why is there a racial disparity in Chronic Disease Emergency Room Visits?
- What can St. Louis do to reduce racial disparities in Chronic Disease Emergency Room Visits?
- What initiatives are currently underway to reduce racial disparities in Chronic Disease Emergency Room Visits?
How can I learn more about this issue?
In 2015, For the Sake of All (now Health Equity Works), a Washington University in St. Louis-based initiative, published a report on the health and well-being of African Americans in St. Louis.