Medically reviewed by Dr. Shani S. Saks, D.O. on August 2, 2023
African American and Latinx individuals with atopic dermatitis (AD) face a greater burden of disease than White people in the United States. A recent study explored the various factors that contribute to disparities in AD care and management among the African American and Latinx populations. Addressing these factors may help solve existing AD-related disparities observed in these demographics.
Structural Racism
The study, published in the Journal of Clinical Immunology, pointed towards structural racism as one of the primary causative agents of AD-related disparity. Structural racism involves systems such as housing, labor, criminal justice, health care, education, and economic systems in which certain groups (typically White) are provided advantages that are denied to African-American, Latinx, and other minority groups. When racism permeates, it can significantly affect various aspects of an individual’s life, including their health.
Socioeconomic Status
Socioeconomic status is a well-established factor that can contribute to increased disease incidence and severity, along with issues related to access to health care. The relationship between socioeconomic status and AD is complex. While higher socioeconomic status is related to a higher prevalence of AD, lower socioeconomic status is linked to increased disease severity and persistence. Patients from lower socioeconomic strata have less access to high-quality health care, which, in turn, can lead to a higher incidence of disease and severity of a condition.
Environmental Exposure
Environmental factors that can negatively influence AD include air pollution, allergens, psychosocial stress, and chemical exposures. Compared to White people, African American and Latinx people have a greater burden of environmental exposure due to long-standing environmental racism and housing discrimination. Dilapidated housing, unclean communities, and garbage on the streets are associated with increased AD severity. Moreover, unsafe and unsupportive neighborhoods are linked to higher severity and prevalence of AD.
Health Care
Health care disparities exist for Black and Latinx populations. Health care quality and access differ across different ethnic groups. African American and other minority group members of lower socioeconomic status do not have access to high-quality health care for AD. Although the disease burden of AD is higher for Black and Latinx individuals, their estimated number of visits to a dermatologist for AD is lower due to issues with access to suitable health care.
Conclusion
African American and Latinx populations in the United States bear a disproportionate burden of AD due to issues rooted in structural racism, socioeconomic status, environmental exposure, and health care access. Addressing these factors can alleviate the burden of AD-related disparities in these ethnic groups.
Source:
Croce, E., Levy, M. L., Adamson, A. S., & Matsui, E. C. (2021b). Reframing racial and ethnic disparities in atopic dermatitis in Black and Latinx populations. The Journal of Allergy and Clinical Immunology, 148(5), 1104–1111. https://doi.org/10.1016/j.jaci.2021.09.015
