4.7 Review

Reframing racial and ethnic disparities in atopic dermatitis in Black and Latinx populations

Journal

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 148, Issue 5, Pages 1104-1111

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2021.09.015

Keywords

Atopic dermatitis; eczema; disparities; race; ethnicity; racism; social determinants of health

Funding

  1. National Institute of Nursing Research of the National Institutes of Health [T32NR019035]
  2. Pfizer Dermatology Research Fellowship
  3. Dermatology Foundation
  4. National Institutes of Health [UL1 TR002645, K24AI114769, R01ES023447, R01ES026170]
  5. American Cancer Society
  6. Robert Wood Johnson Foundation

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Black people in the United States are more likely to experience atopic dermatitis (AD) compared to White people, while there is limited research on AD in the Latinx population. Genetic polymorphisms associated with AD risk and severity are less common among Black people, and socioeconomic, environmental, and health care factors have a significant influence on AD disparities among racial and ethnic minority populations.
Black people in the United States experience greater atopic dermatitis (AD) prevalence, severity, and persistence when compared with White people. Although very little published literature describes AD in the Latinx population, additional differences in severity, persistence, and age of onset exist in contrast to White people. Thus far, genetic polymorphisms associated with increased risk and/or severity of AD are less common among Black people, so should confer reduced, rather than the observed increased, AD risk among Black people. Little is known regarding genetic risk factors in Latinx people. In contrast, there is consistent evidence that socioeconomic, environmental, and health care factors influence AD prevalence, severity, and/or persistence, and these same risk factors are more common among racial and ethnic minority populations as a result of racism. Researchers too often pursue genetic explanations for racial and ethnic AD disparities when the evidence points to the importance of contextual, rather than genetic, causes of these disparities. Reframing the prevailing view that innate differences among racial and ethnic groups are responsible for these disparities by emphasizing the role of racism and its downstream effects on contextual factors will be a critical first step toward shrinking these disparities.

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