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Based on a 2019 study, non-Hispanic Black and Hispanic children have higher rates of school absences due to AD.

Atopic Dermatitis (AD), also known as eczema, is more severe in minority children, with Black children having a higher incidence rate than White or Hispanic children. Based on this 2019 study published in JAMA Dermatology, non-Hispanic black and Hispanic children have higher rates of school absences due to AD.

The researchers used baseline data from children enrolled in the US-based Pediatric Eczema Elective Registry (PEER) between November, 2004, and July, 2017. The children all had physician-confirmed AD diagnoses and were aged 2 to 17 years. 

A total of 8,015 children aged 3.9 -10.4 years old participated in the study. This total included 4,273 (53.3%) girls, 4079 (50.9%) identified as non-Hispanic Black, 2576 (32.1%) identified as non-Hispanic White, and 851(10.6%) identified as Hispanic.

A significant proportion of non-Hispanic black and Hispanic children in the study lived in households with reported incomes below $50,000. Black and Hispanic children were more likely to report uncontrolled AD. The study found that in the last six months, 4835 (60.3%) children reportedly used topical steroids. 

Higher Rates of AD-Related Absences Noted in Younger Children and Those With Longer AD Duration

There were 7272 children enrolled in school or daycare, and 241 (3.3%) reported missing six or more days in the last six months. Non-Hispanic Black and Hispanic children had higher adjusted odds of at least six school AD-related absences than non-Hispanic White children. Factors significantly associated with six or more absences were younger age, a household income between $50,000 and $99,999, uncontrolled and longer duration of AD, and a comorbidity that includes asthma or allergic rhinitis, also known as hay fever. The rate was 1.5 times for non-Hispanic Blacks and 3.4 times more for Hispanic children after controlling for sociodemographic factors, control of AD, health care visits, and atopic comorbidities.

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This study had the following research limitations. The PEER cohort only includes children with previous use of topical medication to decrease inflammation; data were self-reported; and unmeasured variables that are related might account for the observed association.

AD-Related Absences Highest in Non-Hispanic Black Children, Followed by Hispanic Children

The results suggest racial/ethnic disparities in school absenteeism associated with AD that are different from school absence rates in the United States, categorized by race/ethnicity. Per the research article, the US rates for which chronic absenteeism is highest among non-Hispanic Black children (17.3%), followed by Hispanic children (14.1%) and non-Hispanic white children (12.7%). 

Greater Adverse Effects of AD on Minority Children Might Underlie Higher Absence Rates

The researchers felt that further study is needed to examine the differences in these two rates and that their findings might not be generalizable to all children with AD due to the study’s limitations. A possible reason for the higher absence rates in non-Hispanic Black and Hispanic children with AD is that AD might have a greater adverse effect on the quality of life of racial and ethnic minority students. Understanding the factors that influence racial/ethnic differences for AD-related absences can support efforts to reduce school absenteeism that are focused on the “most vulnerable children.”

References

Wan, J., Margolis, D. J., Mitra, N., Hoffstad, O. J., & Takeshita, J. (2019). Racial and Ethnic Differences in Atopic Dermatitis-Related School Absences Among US Children. JAMA Dermatol, 155(8), 973-975. https://doi.org/10.1001/jamadermatol.2019.0597