Atopic dermatitis causes more missed school days among Black, Hispanic children

Black and Hispanic children had a 1.5-fold and 3.4-fold greater chance, respectively, to be absent at least 6 days from school during a 6-month period because of atopic dermatitis vs. white children, after controlling for sociodemographic factors, according to findings in a cross-sectional study.

“Our findings suggest racial/ethnic disparities in school absenteeism associated with [atopic dermatitis] that differ from estimates of school absenteeism by race/ethnicity in the United States which find chronic absenteeism to be highest among non-Hispanic black children (17.3%), followed by Hispanic children (14.1%) and non-Hispanic white children (12.7%),” Joy Wan, MD, MSCE, from the department of dermatology at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues wrote. “In contrast, we observed [atopic dermatitis]-related school absenteeism to be highest among Hispanic children, followed by non-Hispanic black and non-Hispanic white children.”

Researchers used data from the U.S.-based Pediatric Eczema Elective Registry to identify 8,015 children with a physician-confirmed atopic dermatitis (AD) diagnosis. Children and caregivers completed a questionnaire that collected information on demographics, characteristics, medical conditions, AD history, treatment and number of school days missed due to AD in the past 6 months. The primary explanatory variable was self-reported race/ethnicity, categorized as white, black, Hispanic or other.

Six or more reported school days missed due to AD in the previous 6 months was the primary outcome. This approximated the definition of chronic school absenteeism by the U.S. Department of Education. Logistic regression, adjusted for sociodemographic factors, AD control, comorbid atopic disorders and health care utilization, was used to determine the association between race/ethnicity and at least six school absences.

Of the 8,015 children enrolled, 4,079 identified as black, 2,576 as white and 851 as Hispanic. Uncontrolled AD was more likely reported by Black and Hispanic children, according to the study.

“Among the 7,272 children enrolled in school or day care, 241 (3.3%) missed 6 or more days in the last 6 months. Non-Hispanic black (adjusted OR = 1.49; 95% CI, 1.01-2.18) and Hispanic (aOR, 3.41; 95% CI, 2.16-5.38) children had higher adjusted odds of having at least six school absences compared with non-Hispanic white children,” the researchers wrote.

Factors significantly associated with six or more absences were younger age (aOR = 0.95; 95% CI, 0.9-0.999), household income between $50,000 and $99,999 (aOR = 0.55; 95% CI, 0.31-0.97), uncontrolled AD (aOR = 6.36; 95% CI, 2.71-14.89), longer duration of AD (aOR = 1.07; 95% CI, 1.01-1.13), and comorbid asthma (aOR = 1.78; 95% CI, 1.31-2.4) or allergic rhinitis (aOR = 2.03; 95% CI, 1.35-3.05), the researchers reported. – by Monica Jaramillo

Disclosures: The Pediatric Eczema Elective Registry is funded by Valeant Pharmaceuticals. Wan reports she received research fellowship funding from Pfizer to the trustees of the University of Pennsylvania and received payment for consulting work with Health Union. Please see the study for all other authors’ relevant financial disclosures.

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Source:

Wan J, et al. JAMA Dermatol. 2019;doi:10.1001/jamadermatol.2019.0597.