Atopic disease risk increases in sexually diverse patients
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Key takeaways:
- Individuals who identify as sexually diverse are more likely to have asthma, allergic rhinitis and atopic dermatitis.
- Sexual orientation data could help dermatologists identify risk factors for these diseases.
Sexually diverse individuals are at an increased risk for atopic diseases, including asthma, allergic rhinitis and atopic dermatitis, according to a research letter.
“While it is possible that genetic factors could influence these differences, differences in rates of atopic dermatitis among minority groups likely are influenced by environmental and complex sociocultural factors, but also minority stress,” Katelyn J. Rypka, BS, a medical student at University of Minnesota Medical School, and Matthew D. Mansh, MD, assistant professor of dermatology at University of Minnesota, told Healio in a statement.
Researchers conducted a cross-sectional study using data from the 2021 National Health Interview Survey in which age-adjusted prevalence rates and logistic regression were used to calculate adjusted odds ratios of AD, asthma and allergic rhinitis in adults who identified as sexually diverse — which included lesbian, gay, bisexual or “something else” — compared with those who identified as heterosexual.
Of 27,012 respondents, 25,701 (mean age, 48.9 years; 53.7% women) identified as heterosexual and 1,311 (mean age, 36.9 years; 57.9% women) identified as sexually diverse.
Multivariable analysis found 11.1% of sexually diverse subjects reported AD compared with 7.2% of heterosexual individuals (adjusted OR = 1.49; 95% CI, 1.19-1.86). Additionally, asthma was reported in 12% of sexually diverse subjects compared with 7.8% of heterosexual individuals (aOR = 1.39; 95% CI, 1.13-1.71), and allergic rhinitis was reported in 33.7% of the sexually diverse population compared with 25.6% of heterosexual subjects (aOR = 1.3; 95% CI, 1.11-1.51).
While sexually diverse individuals span all socioeconomic classes and are found within all racial and ethnic groups, this increased risk for atopic diseases could be due to unique environmental exposures or sociocultural factors, according to Rypka and Mansh.
“Marginalization, lack of legal protections against discriminatory housing policies and/or enforcement often increases the likelihood of sexually diverse adults to reside and work in neighborhoods with higher rates of hazardous pollution, increased occupational exposures, as well as second-hand smoke inhalation,” Rypka and Mansh told Healio. “Discrimination has also been heavily linked to minority stress, eg, psychological and physical stress put on a person within a minority group due to systemic prejudice and discrimination.”
This information can help dermatologists be aware of these risks and understand the importance of collecting sexual orientation data in their practices.
“While building physician-patient relationships, clinicians should acknowledge that their patients’ diverse identities impact their risk of developing atopic diseases and, likely, the lived experience of having a chronic inflammatory disease,” Rypka and Mansh said. “Physicians should be aware of structural barriers that sexually diverse communities experience and strive to provide culturally sensitive care and equitable access to high-quality medical care for these unique populations.”
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