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Black children less likely to receive treatment for eczema despite increased severity
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Non-Hispanic black children are more likely to use ambulatory health care as well as to seek the care of a dermatologist for the treatment of eczema, according to findings published in the Journal of the American Academy of Dermatology.
“Eczema might be more severe among racial/ethnic minority children, though the exact nature of this relationship remains unclear,” Alexander H. Fischer, MD, MPH, from the department of dermatology at Johns Hopkins School of Medicine, and colleagues wrote. “Although data suggest that at least the physical burden of eczema might be greater among racial/ethnic minority children, it remains unclear if health care utilization for childhood eczema reflects this greater burden.”
To evaluate this health care utilization for pediatric eczema in racial/ethnic minorities throughout the United States, the researchers conducted a cohort study that included non-Hispanic white (reference), non-Hispanic black and Hispanic white children aged younger than 18 years.
All children included had been reported by their caregivers as having eczema and were included in 2-year longitudinal cohorts within the 2001-2013 Medical Expenditure Panel Surveys. Fischer and colleagues assessed health care utilization rates through multivariable regression during a 2-year follow-up period for each race/ethnicity.
Of the 2,043 children included in the study, non-Hispanic blacks used ambulatory visits less than whites for the treatment of eczema (adjusted OR 0.69; 95% CI 0.51-0.92). Non-Hispanic black children were also more likely to have ambulatory visits related to eczema of than white children (IRRadj 1.22; 95% CI .1-1.46) and were more likely to visit a dermatologist (aOR 1.82; 95% CI 1.06-3.14).
“Importantly, our findings were independent of baseline sociodemographic factors, health insurance status and presence of atopic comorbidities, all of which might have affected access to health care, suggesting that race alone predicts whether or not a child sees a medical provider for eczema in the ambulatory setting,” Fischer and colleagues wrote.” – by Katherine Bortz
Disclosure: The authors report no relevant financial disclosures.
Perspective
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Emma Guttman-Yassky, MD, PhD
The important study by Fischer et al. sheds light on health care disparities related to ethnic background among children with atopic dermatitis/eczema. Despite a higher prevalence of eczema — and possibly a more resistant to treatment clinical disease phenotype that has been previously reported among African American and Hispanic populations — these populations have significantly fewer visits to health care providers to obtain care.
These data suggest that special efforts need to be made for bringing new treatment developments to this high-need population, as untreated eczema in these children may contribute to future disparities in school and other performances.
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