RACIAL DIFFERENCES IN FOOD ALLERGY DIAGNOSIS AMONG CHILDREN WITH ATOPIC DERMATITIS INDEPENDENT OF SOCIOECONOMIC CONDITION

Abstract

<h3>Introduction</h3> It is well-known that children with atopic dermatitis are at increased risk of developing food allergy. To deepen this understanding, we explored the possible association of race and socioeconomic condition with diagnosis of food allergy in children with atopic dermatitis. <h3>Methods</h3> We conducted a large single-center retrospective cohort study of children aged 0-18 years with atopic dermatitis to determine whether each child had a food allergy diagnosis. We performed logistic regression, adjusting for age, race, sex, BMI, and indicators of socioeconomic condition [insurance status and Area Deprivation Index (ADI)]. <h3>Results</h3> Among the 4,322 children analyzed for this study, 16% were Non-Hispanic White, 39% Black, 33% Hispanic, and 6% Asian. Compared with non-Hispanic White children with atopic dermatitis, Hispanic children with atopic dermatitis were significantly less likely to have a food allergy diagnosis (OR=0.774, 95% CI [0.689-0.983], p=0.036). Conversely, both Black children and Asian children with atopic dermatitis were more likely to have been diagnosed with food allergy (OR=1.293, 95% CI [1.109-1.642], p=0.035 and OR=1.493, 95% CI [1.075-2.073], p=0.017 respectively). Age, male gender, non-Medicaid insurance, and lower area deprivation (higher socioeconomic condition) were all statistically significantly associated with increased risk of food allergy diagnosis. <h3>Conclusion</h3> The association between race/ethnicity and risk of food allergy diagnosis among children with atopic dermatitis persisted after thoroughly adjusting for socioeconomic condition using two different markers (insurance status and ADI). Clearly defining which children with atopic dermatitis are at highest risk of developing food allergies can help inform future efforts in early food allergy diagnosis and prevention.