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Racial and Ethnic Disparities in Pediatric Atopic Dermatitis
Urdur Jonsdottir1, Emily S Craver2, Tanvi R Patel3
1From the Department of Pediatrics, Nemours Children's Health, Orlando, Florida.
Insights
Racial and ethnic disparities impact healthcare access for children with atopic dermatitis (AD). Hispanic and Black children utilized urgent and emergency care more often than White children, highlighting a need for equitable treatment strategies.
Area of Science:
- Pediatric Dermatology
- Health Services Research
- Health Equity
Background:
- Atopic dermatitis (AD) is a prevalent chronic childhood condition.
- Disparities in care access can lead to suboptimal disease management and reduced quality of life.
Purpose of the Study:
- To investigate if race and ethnicity influence treatment and healthcare utilization for pediatric atopic dermatitis in central Florida.
Main Methods:
- A study of 4008 children with AD compared healthcare utilization metrics across racial and ethnic groups.
- Metrics included AD-related healthcare visits, prescriptions, testing, and subspecialty referrals.
- Multivariable models adjusted for confounders to compare Black, Hispanic, Asian, and Other groups against non-Hispanic White patients.
Main Results:
- Hispanic children had significantly higher urgent care (1.61x) and emergency department (3.71x) visits compared to non-Hispanic White children.
- Black or African American patients showed higher emergency department visits (1.52x).
- Primary care visit counts differed by ethnicity, with no significant disparities in subspecialty visits, hospitalizations, prescriptions, or testing.
Conclusions:
- Significant racial and ethnic disparities in healthcare utilization exist for pediatric atopic dermatitis.
- Further research is crucial to understand and address the root causes of these disparities to achieve health equity.
Objectives:
Atopic dermatitis (AD) is one of the most common chronic childhood conditions. Disparities in treatment and access to care can result in poor disease control and decreased quality of life. The aim of this study was to determine whether race and ethnicity affect treatment and healthcare utilization for pediatric atopic dermatitis in central Florida.
Methods:
This study of 4008 children with AD compared healthcare utilization and management using the numbers of AD-related healthcare visits, prescriptions, testing, and subspecialty referrals. Multivariable models were used to compare racial and ethnic groups (Black, Hispanic, Asian, and Other) with the reference group of non-Hispanic White, while adjusting for common confounders.
Results:
The mean number of urgent care visits for the Hispanic group was 1.61 times that of the non-Hispanic White group, and the mean number of emergency department visits was 3.71 (P < 0.001) times the reference group. Black or African American patients had a mean number of emergency department visits that was 1.52 times that of non-Hispanic White patients (P = 0.021). The mean count of primary care visits was lower among Hispanic patients and higher among Asian patients (P = 0.012). Visits to subspecialty clinics and hospitalizations did not differ significantly. There were no consistent patterns in differences of AD-related prescriptions, testing, or subspecialty referrals.
Conclusions:
This study indicates that racial and ethnic disparities exist in healthcare utilization in pediatric AD. The underlying factors contributing to these disparities need to be further studied and addressed to reach health equity within pediatric AD.
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