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Black Children with Atopic Dermatitis Less Likely to be Evaluated by Allergists than Their White Peers

AAAAI News Release

February 3, 2023

April Presnell, Media & Member Communications Manager
(414) 272-6071

Research being presented at the 2023 AAAAI Annual Meeting examines racial disparities in the atopic march, which can help predict the progression of allergic diseases early in life.

Milwaukee, WI – Despite research showing that black children are more likely to develop asthma, researchers found that black children diagnosed with atopic dermatitis were less likely to be evaluated by an allergist than white children. This research will be presented in full at the 2023 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).

The atopic march typically begins early in life with atopic dermatitis (also known as "eczema"), and can eventually progress to the development of asthma, along with environmental and food allergies. “We already know that black children have higher rates of asthma,” said Ellen D. Stephen, MD, first author of the study. “But the atopic march has just not been studied in black children as widely as it has in white children.”

Researchers performed a retrospective chart review of children aged 0-18 years diagnosed with atopic dermatitis at a single center to determine if each patient was diagnosed with asthma, and if they were evaluated for asthma. Logistic regression was used to analyze the risk of asthma diagnosis and its association with race, sex, age, body mass index (BMI), insurance, and the Area Deprivation Index (ADI).

A total of 728 black children and 246 non-Hispanic white children with atopic dermatitis were identified. Among those in the study, 31.2% of black children were likely to have an asthma diagnosis, compared to 10% of white children. Analysis found that higher ADI, higher BMI, and greater age at time of evaluation were the factors most likely to impact the differences. Only 46.7% of black children were evaluated by an allergist, compared to 69% of white children. Black children were also significantly less likely to have undergone testing to environmental allergens.

“Asthma is a common, potentially life-threatening condition affecting the children in our country and allergist evaluation and environmental allergy testing can be essential to optimizing control of this disease," said Dr. Stephen. "To minimize existing healthcare disparities, more research must be done to help us understand what factors underlie the observed differences in the diagnosis and management of atopic diseases, so that we can overcome existing barriers to providing equitable asthma care”

Visit to learn more about atopic dermatitis and asthma. Research presented at the AAAAI Annual Meeting, February 24-27 in San Antonio, Texas, is published in an online supplement to The Journal of Allergy and Clinical Immunology.

The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. The AAAAI is the go-to resource for patients living with allergies, asthma and immune deficiency disorders. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.