USING AREA DEPRIVATION INDEX TO ASSESS RACIAL DISPARITIES IN ASTHMA AMONG CHILDREN WITH FOOD ALLERGY

Abstract

<h3>Introduction</h3> Previous studies have shown significant racial disparities in food allergy (FA) phenotype and outcomes. Our study sought to understand if higher rates of asthma in African American (AA) children with FA were driven by differences in individual and community-level socioeconomic status (SES), regardless of race. <h3>Methods</h3> We analyzed data from FORWARD, which is a prospective, multicenter cohort study investigating the natural history of pediatric atopy. A validated, multi-component area deprivation index (ADI) was used to estimate patient exposure to low SES at the local census block group level. Higher ADI is associated with greater socioeconomic disadvantage. <h3>Results</h3> Of the 700 children in this study, 51% were non-Hispanic White, 37% AA, and 12% Hispanic. The mean ADI across the analytic sample was 37.7 (95% CI: 35.6-39.7). The highest mean ADI (51.5) was seen among AA patients when compared to non-Hispanic White (mean ADI of 24.2) and Hispanic (mean ADI of 41) patients (p < .0001). The mean ADI was 43.3 in children with asthma as opposed to 31.8 in those without asthma (p < .0001). Asthma was more common among AA children [OR = 2.76 (95% CI: 1.77-4.29)] after adjusting for household income, respondent educational attainment, child gender, and recruitment site. <h3>Conclusion</h3> Our data shows that higher ADI is independently associated with higher odds of asthma among children with FA. These findings demonstrate the role of socioeconomic deprivation in the development of asthma among children with FA. This is especially important considering the obstacles associated with socioeconomic deprivation that hinder appropriate management of asthma.