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Assessing Disparities in the Prevalence of Atopic Comorbidities Among Food-Allergic Children

Anandu Dileep1, Christopher Warren2, Lucy A Bilaver3

  • 1Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill.

The Journal of Allergy and Clinical Immunology. in Practice
|January 31, 2023
PubMed

Insights

Socioeconomic deprivation in neighborhoods is linked to atopic conditions like asthma and allergic rhinitis in children with food allergies. Black children with food allergies still face higher asthma risks, even after accounting for socioeconomic factors.

Area of Science:

  • Pediatric Allergy and Immunology
  • Social Determinants of Health
  • Epidemiology

Background:

  • Black children with food allergy (FA) exhibit a higher prevalence of atopic comorbidities compared to White children.
  • Socioeconomic status (SES) may explain these observed racial disparities in atopic comorbidity risk.

Purpose of the Study:

  • To investigate whether individual and community-level socioeconomic status (SES) drive disparities in atopic comorbidity prevalence among children with FA.
  • To assess the association between neighborhood-level socioeconomic deprivation and atopic comorbidities in children with FA.

Main Methods:

  • Analysis of data from the prospective, multicenter Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD) study.
  • Utilized a validated area deprivation index (ADI) based on census block group for each participant's address.
  • Assessed the association of ADI with atopic comorbidities in FA using multivariable regression analysis, adjusting for relevant factors.

Main Results:

  • A higher mean ADI was observed in children with asthma (43.3) and allergic rhinitis (AR) (39.1) compared to those without these conditions (31.8 and 33.4, respectively).
  • ADI was significantly associated with asthma (P < .0001) and AR (P = .008), independent of race.
  • ADI demonstrated associations with secondhand smoke exposure, parental education, and household income.
  • Black children with FA showed a higher risk for asthma even after adjusting for ADI and other SES-related factors.

Conclusions:

  • Neighborhood-level socioeconomic deprivation, indicated by ADI, is independently associated with asthma and AR in children with FA, irrespective of race.
  • Despite accounting for SES, Black children with FA continue to exhibit an elevated risk for asthma, suggesting potential independent risk factors beyond socioeconomic status.
Abstract

Keywords:
Allergic rhinitisAsthmaDisparitiesEczemaFORWARDFood allergyRaceSocioeconomic

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