Racial disparities in emergency department visitation among children with atopic comorbidities
Published online July 16, 2024
Atopic diseases and their associated comorbidities are prevalent among children, yet racial differences in emergency department (ED) visitation related to these conditions remain underexplored.
In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Correa et al. reviewed electronic health record (EHR) data from Cincinnati Children’s Hospital. The study included patients (<21 years) who had at least one ED visit for atopic dermatitis (AD), food allergy (FA), asthma, allergic rhinitis (AR), or eosinophilic esophagitis (EoE) from 2015 to 2019 and who were identified as Black/African American (AA) or White/European American (EA). The researchers assessed the probability of ED encounter-free time using hazard ratios and time to recurrence of ED encounters for AA and EA children, considering potentially underlying allergic, demographic, and place-based factors, as well as potential interactions between these factors.
A total of 30,894 patients (38% AA and 62% EA) accounted for 83,078 ED encounters during the study period. AA children exhibited a higher Hazard Ratio (HR) for ED encounters following initial AD and asthma diagnoses. Among AA children, those insured by Medicaid had a higher HR for any ED encounter compared to those with commercial insurance. In contrast, EA children with Medicaid showed a lower HR than their commercially insured peers. AA children also experienced shorter intervals free from recurrent ED encounters for AD, FA, and asthma. Regardless of race, allergic comorbidity increased the HR of ED encounters (1.12-1.62) for all allergic diseases.
The study revealed that racial disparities in ED visitation for atopic comorbidities were primarily driven by socioeconomic factors and underlying allergic conditions. Notably, AA children exhibited a higher hazard for ED encounters related to AD and asthma and experienced shorter intervals free of recurrent ED encounters (i.e., more frequent ED visits) for AD, FA, and asthma compared to EA children. These findings highlight the need for targeted prevention strategies both before and during emergency care to address identified racial disparities in atopic comorbidity.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.
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