Published Online: August 2, 2012
Racial differences in the occurrence and severity of allergic diseases such as eczema and asthma have been reported with Black individuals tending to experience more disease and more severe disease. However, most prior research on racial disparities in allergic diseases has focused on children. A new study appearing in The Journal of Allergy and Clinical Immunology (JACI) adds novel information about racial differences in allergic disease occurrence that were observed in a group of pregnant women.
In the Wayne County Health, Environment, Allergy, and Asthma Longitudinal Study or “WHEALS”, children are being studied from birth throughout early life to investigate causes of pediatric allergy and asthma. Their mothers were recruited for this research project during pregnancy. In the study from Wegienka et al., the health histories of these pregnant women were investigated to compare the rates of allergic diseases between Black and White women in the Detroit, Michigan, area. Women were asked if they ever had prior doctor diagnoses of asthma, eczema/atopic dermatitis, or hay fever/allergic rhinitis. Blood samples from the women were also analyzed for markers of allergy called IgE (total and allergen-specific). The authors compared the rates of the diagnoses and positive allergen-specific IgEs and total IgE levels between 563 Black women and 219 White women. The analyses adjusted for various factors that differed between the groups including maternal smoking, indoor pets, income, education, age, and allergen (dog, cat, and cockroach) and endotoxin levels in the home.
Black women were more likely than White women to have at least one positive allergen-specific IgE (62.5% versus 40.2%). Black women also had higher total IgE. Black women were more likely to have had a prior doctor diagnosis of asthma (22.7% versus 16.0%) and eczema (21.9% versus 14.8%) but not hay fever (White 17.5% versus Black 15.7%). These racial differences persisted for total IgE, having ≥1 positive allergen-specific IgE and having a prior doctor diagnosis of eczema after adjusting for common socio-economic and environmental variables. After adjusting for these additional factors, the rates of asthma were not statistically significantly different.
Black women were also more likely to have ever had a doctor diagnosis of an allergic disease as well as more positive allergen-specific IgEs compared to White women even after adjusting for some differing environmental and social factors. While disease management is important, disease prevention is essential as well. As researchers work to assess the scope of racial differences in allergic diseases in adult women, the sources of these differences remain unknown. These findings suggest that studies specifically designed to address sources of racial disparities are badly needed and will serve to improve the health of all individuals.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.