Our study sought to understand if disparities in the prevalence of atopic comorbidities among children with FA are driven by individual and community-level socioeconomic status (SES).
We analyzed data from a prospective, multicenter cohort investigating the natural history of pediatric atopy: the Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD) study. A validated, multicomponent area deprivation index (ADI) percentile score was tabulated by the census block group for each subject\'s home address. The association of ADI with atopic comorbidities in FA was assessed via multivariable regression analysis.
Of the 700 children in this study, the mean ADI was 37.7 (95% confidence interval: 35.6-39.7). The mean ADI was higher in children with asthma (43.3) compared with those without asthma (31.8), which remained significant after adjusting for race (P < .0001). Children with allergic rhinitis (AR) had a higher mean ADI (39.1) compared with those without (33.4) (P = .008). ADI was associated with secondhand smoking, parents\' education, and household income. Black children had a higher risk for asthma after adjusting for ADI and SES-related factors.
The independent association of ADI with asthma and AR, regardless of race, suggests a role of neighborhood-level socioeconomic deprivation in the development of these conditions among children with FA. Black children with FA remained at higher risk for asthma after adjusting for SES-related variables, which can indicate an independent risk for asthma in these children.
目的:我们的研究试图了解FA儿童特应性合并症患病率的差异是否由个体和社区水平的社会经济地位(SES)驱动。
方法:我们分析了来自前瞻性,多中心队列研究小儿特应性疾病的自然史;食物过敏结果与白人和非裔美国人种族差异相关(FORWARD)研究。一个经过验证的,多分量区域剥夺指数(ADI)百分位数得分按人口普查区组为每个受试者的家庭住址。通过多变量回归分析评估了ADI与FA中特应性合并症的相关性。
结果:在这项研究的700名儿童中,平均ADI为37.7(95%CI:35.6-39.7)。哮喘患儿的平均ADI(43.3)高于无哮喘患儿(31.8),在调整种族后仍然很重要(p<0.0001)。与没有过敏性鼻炎(AR)的儿童相比,有较高的平均ADI(39.1);p=0.008。ADI与二手烟有关,父母的教育,和家庭收入。调整ADI和SES相关因素后,黑人儿童患哮喘的风险更高。
结论:ADI与哮喘和AR的独立关联,不管种族,表明社区水平的社会经济剥夺在FA儿童中这些疾病的发展中的作用。在调整SES相关变量后,患有FA的黑人儿童患哮喘的风险仍然较高,这可以表明这些儿童患哮喘的独立风险。