School-based Stock Inhaler Programs and Neighborhood Disadvantage

Introduction. Ensuring students with asthma residing in disadvantaged communities have access to rescue medication (albuterol) is important. Methods. Using the Area Deprivation Index (ADI), we examined relationships between albuterol use and neighborhood deprivation among schools participating in the Pima County (Arizona) Stock Inhaler Program. Schools were categorized into quartiles based on their census block ADI. A hurdle regression examined associations between ADI and stock inhaler use after controlling for school characteristics. Results. Among 228 participating schools, only those in the second worst ADI quartile were more likely to use a stock inhaler than those in the most deprived quartile (referent), OR 1.9 (95% CI 1.2-2.9). Middle schools had 2.1 times higher odds (95% CI 1.3-3.4) of ever using a stock inhaler than elementary schools (referent). Conclusion. Students attending schools in the second most deprived communities, as opposed to most deprived, may have the most tenuous albuterol access.