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Studies Presented at AAAAI Examine US Racial, Ethnic Disparities for Individuals With Asthma, Eczema

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How asthma and other skin conditions cluster in Black children and a finding of increased risk of respiratory infections in Black and Mexican-American children with asthma were among the studies presented at the American Academy of Allergy, Asthma, and Immunology (AAAAI) conference.

Various abstracts presented at the American Academy of Allergy, Asthma, and Immunology (AAAAI) conference highlighted racial disparities that impact treatment and clinical outcomes for adults and children with asthma and other atopic conditions.

How asthma, skin conditions cluster in Black children

It is already known that Black children have higher rates of asthma and eczema than White children, but how these conditions appear together in Black children is unknown. The University of Texas at Austin and Dell Medical School analyzed National Health Survey interview data from 2018, finding Black children had 1.5-fold higher prevalence of atopic dermatitis (AD), 2.4-fold higher prevalence of asthma, and 3-fold higher prevalence of comorbid asthma and eczema than White children.1 The high prevalence of asthma and eczema may have negative impacts on factors such as quality of life, school attendance, behavior, and mental health, the authors said.

Survey-weighted estimated prevalence of the different conditions were:

  • Eczema among Black children: 18.4% (95% CI, 15.4-21.4)
  • Eczema among White children: 12.1% (95% CI, 10.9-13.4)
  • Asthma among Black children: 13.9% (95% CI, 11.4-16.5)
  • Asthma among White children: 5.8% (95% CI, 5.0-6.6)
  • Asthma and eczema among Black children: 1.5% (95% CI, 1.1-1.9)
  • Asthma and eczema among White children: 4.6% (95% CI, 3.0-6.1)

Additional research is needed to understand the common risk factors for both conditions in Black populations in order to identify targeted therapies and interventions, the authors said.

Increased risk of respiratory infection in Black and Mexican-American children with asthma

Another University of Texas and Dell Medical School study examined the impact of an upper respiratory viral infection (URI) on the lungs among different racial and ethnic groups.2 Data came from the National Health and Nutritional Examination Survey (2007-2012) and included information on children aged 6-17 with asthma. Researchers used survey-weighted generalized linear models to estimate the association of self-reported cold (URI, such as cough, cold, phlegm, runny nose, or other respiratory illness) to race/ethnicity.

They also examined the effect of URI on fractional exhaled nitric oxide (FENO), or lung function (% predicted forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity [FVC]), varied by race/ethnicity. Models were adjusted for age, sex, household size, health insurance, and income.

Results showed that Black and Mexican-American children had increased odds of URI compared with White children (OR, 1.88; 95% CI, 1.12-3.14 vs OR, 1.92; 95% CI, 0.76-4.82).

However, having a URI did not appear to impact lung function, although FENO was 26% higher among children with a URI compared with children without a URI. In addition, neither URI or FENO varied by race or ethnicity. “URIs do not appear to manifest differently in the lung, suggesting that disparities in asthma exacerbations could be driven instead by differences in risk of infection,” the authors wrote.

References

1. Croce E, Bhavnani, D, Varshney P, et al. Racial disparities in burden of comorbid asthma and eczema. Abstract presented at: American Academy of Allergy, Asthma & Immunology; February 25, 2023. San Antonio, Texas. Session 202.

2. Bhavnani D, Chambliss S, Rathouz P, et al. Are black and latinx children with asthma more vulnerable than white children to upper respiratory viral infection? Abstract presented at: American Academy of Allergy, Asthma & Immunology; February 25, 2023. San Antonio, Texas. Session 234.

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