Lower socioeconomic status may help explain racial disparities in asthma and atopic dermatitis prevalence: A mediation analysis.
J Allergy Clin Immunol 2024;
153:1140-1147.e3. [PMID:
37995856 PMCID:
PMC11046418 DOI:
10.1016/j.jaci.2023.11.013]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/09/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND
Racial disparities in atopic disease (atopic dermatitis [AD], asthma, and allergies) prevalence are well documented. Despite strong associations between race and socioeconomic deprivation in the United States, and socioeconomic status (SES) and atopic diseases, the extent to which SES explains these disparities is not fully understood.
OBJECTIVE
We sought to identify racial disparities in childhood atopic disease prevalence and determine what proportion of those disparities is mediated by SES.
METHODS
This study used the National Health Interview Survey (2011-2018) to investigate AD, asthma, and respiratory allergy prevalence in Black and White children and the extent to which measures of SES explain any identified disparities.
RESULTS
By race, prevalences were as follows: AD, White 11.8% (95% CI: 11.4%, 12.2%) and Black 17.4% (95% CI: 16.6%, 18.3%); asthma prevalence, White 7.4% (95% CI: 7.0%, 7.7%) and Black 14.3% (95% CI: 13.5%, 15.0%); respiratory allergy, White 11.4% (95% CI: 11.0%, 11.9%) and Black 10.9% (95% CI: 10.3%, 11.6%). The percentage of the disparity between racial groups and disease prevalence explained by a multivariable measure of SES was 25% (95% CI: 15%, 36%) for Black versus White children with AD and 47% (95% CI: 40%, 54%) for Black versus White children with asthma.
CONCLUSIONS
In a nationally representative US population, Black children had higher prevalence of AD and asthma than White children did and similar prevalence of respiratory allergy; a multivariable SES measure explained a proportion of the association between Black versus White race and AD and a much larger proportion for asthma.
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