An Americas Health Foundation panel agreed on the significant prevalence of health disparities related to atopic dermatitis in Latin America. They identified the factors contributing to these disparities and developed expert recommendations.
Atopic Dermatitis (AD) is a chronic, heterogeneous skin disease. The condition has multiple risk factors, including genetics, environmental factors, immunological factors, and more. It is a condition that predominantly occurs during childhood, and most outgrow it. AD affects 5–25% of children in Latin America (LA), and 10–30% of patients continue to have symptoms during adulthood. However, in some instances, it may also begin during adolescence or adulthood. Health disparities are known to exist in various parts of the world, including LA. However, there is a limited understanding of how health disparities affect the quality of life (QoL) of AD patients in LA.
Americas Health Foundation Panel Identified Factors Contributing to Atopic Dermatitis Disparities
In April 2022, the Americas Health Foundation (AHF) gathered a panel of six pediatric dermatologists from Uruguay, Colombia, Brazil, Argentina, Chile, and Mexico. These experts participated in a 3-day conference. During their gathering, they reviewed the literature, shared their expert opinions, and contacted various regional opinion leaders to identify how health disparities affect AD patients for the purpose of developing expert recommendations to overcome these inequalities. The findings and recommendations of the expert panel were published in the journal Dermatology and Therapy.
The experts agreed that healthcare disparities are a complex topic affected by socioeconomic, political, racial, and regional factors. They also agreed that AD has a greater effect on the QoL of less educated people who belong to lower socioeconomic groups. Health disparities result in some people suffering from more severe disease than others. Lower economic status results in less access to topical and systemic steroids, laboratory tests, and medical care. Further, people of lower socioeconomic status are more likely to live in environments with greater air pollution, factory emissions, and water hardness, which increases their risk of AD. For example, children living near factories in Buenos Aires, Argentina, were twice as likely to develop AD.
Further, the AHF panel identified a need to harmonize AD diagnosis. Present clinical practice guidelines suffer from bias and lack applicability. Several clinical guidelines exist in the region that only contribute to the confusion and health disparities. Further, there is an urgent need to enhance treatment access, especially for those with non-respondent disease who need systemic immunosuppressants, Janus kinase inhibitors, and biologics. Further, there is limited access to AD specialists in LA. Online surveys in Argentina and Brazil showed that 40–80% of patients are dissatisfied with the treatment.
The Bottom Line
The AHF panel identified significant health disparities in AD. To overcome these inequalities, there is a need to enhance access to the healthcare system throughout LA and improve access to AD specialists. There is also a need to counter economic and nutritional inequalities and an urgent need to develop harmonized clinical guidelines for the condition and enhance patient education. Further, the expert panel agreed on the need to leverage telemedicine, which may improve access to information and specialists, thus helping overcome the disparities.
Source:
Sánchez, J., Ale, I., Angles, M. V., Guidos, G., Jansen, A. M., Takaoka, R., & Borzutzky, A. (2022). Healthcare disparities in atopic dermatitis in Latin America: A Narrative review. Dermatology and Therapy, 13(2), 399–416. https://doi.org/10.1007/s13555-022-00875-y
