Advancing equity in allergy and immunology: progress, pitfalls, and the path forward

Health disparities in allergic and immunologic conditions are shaped by unequal exposure to social determinants of health (SDoH), including education, healthcare quality, neighborhood and built environment, social context, and economic stability. This review summarizes recent literature on disparities across asthma, food allergy, eosinophilic esophagitis, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, drug allergy, and primary immunodeficiency. Marginalized populations-including Black, Latinx, and low-income individuals-experience delayed diagnoses, limited access to specialist care, underuse of evidence-based therapies, and disproportionate exposure to environmental triggers. The manuscript highlights successful interventions including community health worker-led outreach, school-based programs, housing modifications, and policy reforms addressing affordability, housing, and environmental quality. However, recent cuts to federal agency staffing and funding jeopardize continued progress, threatening public health infrastructure that supports equitable care for many diseases. Sustained investment, interdisciplinary collaboration, and policy-driven strategies remain critical to addressing persistent inequities and improving outcomes in historically underserved communities.