Examining Disparities in Pediatric Eosinophilic Esophagitis

Area of Science:

• Pediatric Gastroenterology
• Health Disparities Research
• Eosinophilic Esophagitis (EoE) Epidemiology

Background:

• Limited understanding of how race, ethnicity, and socioeconomic status influence health outcomes in pediatric eosinophilic esophagitis (EoE).
• Need to investigate demographic disparities in the diagnosis and management of EoE in children.

Purpose of the Study:

• To identify demographic characteristics of children diagnosed with EoE at a major tertiary care center.
• To determine associations between patient demographics and the extent of diagnostic evaluation or treatment decisions.

Main Methods:

• Retrospective cohort study of 2,117 children (0-18 years) with EoE from 2009-2020.
• Utilized electronic medical records for demographic data, Area Deprivation Index (ADI) for socioeconomic status, and Rural-Urban Commuting Area codes for urbanization.
• Employed descriptive statistics and regression analysis to assess associations.

Main Results:

• Children with higher ADI scores (greater neighborhood disadvantage) underwent less radiographic evaluation and received esophageal dilations at younger ages.
• Black children were diagnosed at younger ages compared to White children.
• Children from rural areas had less access to feeding therapy and were younger at their initial visits.

Conclusions:

• Significant differences in the presentation and care of pediatric eosinophilic esophagitis (EoE) were observed based on race, urbanization, and socioeconomic status.
• Findings highlight the need for equitable care models to address disparities in pediatric EoE management.