Race and ethnicity: Risk factors for fungal infections?

Area of Science:

• Mycology
• Infectious Diseases
• Health Disparities

Background:

• Racial and ethnic identities, primarily social constructs, can affect susceptibility to infectious diseases, including fungal infections.
• Factors such as genetic, immunologic, and epigenomic differences, alongside social determinants of health, contribute to varied risks.
• Pre-existing conditions and unequal healthcare access further exacerbate risks for certain racial and ethnic groups.

Purpose of the Study:

• To review racial and ethnic identities as risk factors for acquiring fungal infections.
• To examine the relationship between race/ethnicity and the risk of severe fungal disease.

Main Methods:

• Literature review analyzing studies on race, ethnicity, and fungal infections.
• Synthesis of data on risk factors, including immunologic, genetic, environmental, and socioeconomic elements.

Main Results:

• Invasive mold infections (e.g., aspergillosis) are linked to environmental factors and social determinants, with immunologic factors playing a secondary role.
• Black and African American individuals show higher risk for Candida infections and cryptococcosis, though reasons are multifactorial, involving social determinants and healthcare access.
• Endemic fungal infections are strongly associated with social determinants, socioeconomic status, and health disparities, with immunologic mechanisms being relevant in specific cases like disseminated coccidioidomycosis.

Conclusions:

• Social determinants of health, socioeconomic factors, and healthcare disparities are primary drivers of fungal infection risk across racial and ethnic groups.
• While immunologic and genetic factors can contribute, environmental exposures and social contexts play a significant role in fungal disease acquisition and severity.
• Further research is needed to elucidate the complex interplay between race, ethnicity, social factors, and fungal pathogenesis.