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Onychomycosis in underrepresented groups: an all of us database analysis
Isabelle Moseley1, Sara D Ragi2, Samantha Ouellette3
1The Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI, 02903, USA. isabelle_moseley@brown.edu.
Archives of Dermatological Research
|October 19, 2022
Summary
Onychomycosis, a fungal nail infection, disproportionately affects underrepresented racial and ethnic groups in the US. This study highlights the need for targeted research and interventions to address this health disparity.
Area of Science:
- Dermatology
- Precision Medicine
- Health Disparities
Background:
- Few US dermatologic disease studies adequately include underrepresented populations.
- The All of Us (AoU) initiative prioritizes data collection from diverse populations.
- Onychomycosis prevalence data is lacking in these key demographic groups.
Purpose of the Study:
- To evaluate the burden of onychomycosis in underrepresented groups within the US.
- To identify disparities in onychomycosis prevalence based on race, ethnicity, age, disability, sexual orientation/gender identity, income, and education.
- To leverage the All of Us research initiative data for population health insights.
Main Methods:
- Cross-sectional analysis of the AoU Registered Tier dataset (v5, May 2017-April 2021).
- Linked survey and electronic health record (EHR) data for 329,038 participants (251,597 with EHR data).
- Multivariate logistic regression adjusted for relevant covariates to estimate onychomycosis odds.
Main Results:
- Overall onychomycosis prevalence was 5.5% (13,874 cases).
- Black and Hispanic participants showed higher adjusted odds of onychomycosis compared to White participants (ORs 1.29 and 1.24, respectively).
- Higher adjusted odds were observed across various underrepresented groups.
Conclusions:
- Findings suggest a disproportionately high burden of onychomycosis in underrepresented populations.
- Onychomycosis prevalence disparities warrant further investigation and targeted public health strategies.
- Replication studies are needed to confirm and address these identified health inequities.
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