Racial disparities in allergic outcomes in African Americans emerge as early as age 2 years

G. Wegienka, S. Havstad, C. L M Joseph, E. Zoratti, Dennis Randall Ownby, K. Woodcroft, C. C. Johnson

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background Racial disparities in allergic disease outcomes have been reported with African Americans suffering disproportionately compared to White individuals. Objective To examine whether or not racial disparities are present as early as age 2 years in a racially diverse birth cohort in the Detroit metropolitan area. Methods All children who were participants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physician exam with skin prick testing and parental interview at age 2 years. Physicians made inquiries regarding wheezing and allergy symptoms and inspected for and graded any atopic dermatitis (AD). Skin testing was performed for Alternaria, cat, cockroach, dog, Dermatophagoides farinae (Der F), Short Ragweed, Timothy grass, egg, milk and peanut. Specific IgE was measured for these same allergens and total IgE was determined. Results African American children (n = 466) were more likely than White children (n = 223) to have experienced any of the outcomes examined: at least 1 positive skin prick test from the panel of 10 allergens (21.7% vs. 11.0%, P = 0.001); at least one specific IgE ≥ 0.35 IU/mL (out of a panel of 10 allergens) (54.0% vs. 42.9%, P = 0.02); had AD (27.0% vs. 13.5%, Chi-square P < 0.001); and to ever have wheezed (44.9% vs. 36.0%, P = 0.03). African American children also tended to have higher total IgE (geometric means 23.4 IU/mL (95%CI 20.8, 27.6) vs. 16.7 IU/mL (95%CI 13.6, 20.6 IU/mL), Wilcoxon Rank Sum P = 0.004). With the exception of wheezing, the associations did not vary after adjusting for common social economic status variables (e.g. household income), environmental variables (endotoxin; dog, cat and cockroach allergen in house dust) or variables that differed between the racial groups (e.g. breastfeeding). After adjustment, the wheeze difference was ameliorated. Conclusions With disparities emerging as early as age 2 years, investigations into sources of the disparities should include the prenatal period and early life.

Original languageEnglish (US)
Pages (from-to)909-917
Number of pages9
JournalClinical and Experimental Allergy
Volume42
Issue number6
DOIs
StatePublished - Jun 1 2012

Fingerprint

African Americans
Allergens
Immunoglobulin E
Cockroaches
Respiratory Sounds
Atopic Dermatitis
Cats
Phleum
Dermatophagoides farinae
Parturition
Dogs
Physicians
Ambrosia
Social Adjustment
Alternaria
Skin
Skin Tests
Breast Feeding
Dust
Endotoxins

Keywords

  • Allergic disease
  • Atopy
  • Ige
  • Racial disparities

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Racial disparities in allergic outcomes in African Americans emerge as early as age 2 years. / Wegienka, G.; Havstad, S.; Joseph, C. L M; Zoratti, E.; Ownby, Dennis Randall; Woodcroft, K.; Johnson, C. C.

In: Clinical and Experimental Allergy, Vol. 42, No. 6, 01.06.2012, p. 909-917.

Research output: Contribution to journalArticle

Wegienka, G. ; Havstad, S. ; Joseph, C. L M ; Zoratti, E. ; Ownby, Dennis Randall ; Woodcroft, K. ; Johnson, C. C. / Racial disparities in allergic outcomes in African Americans emerge as early as age 2 years. In: Clinical and Experimental Allergy. 2012 ; Vol. 42, No. 6. pp. 909-917.
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abstract = "Background Racial disparities in allergic disease outcomes have been reported with African Americans suffering disproportionately compared to White individuals. Objective To examine whether or not racial disparities are present as early as age 2 years in a racially diverse birth cohort in the Detroit metropolitan area. Methods All children who were participants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physician exam with skin prick testing and parental interview at age 2 years. Physicians made inquiries regarding wheezing and allergy symptoms and inspected for and graded any atopic dermatitis (AD). Skin testing was performed for Alternaria, cat, cockroach, dog, Dermatophagoides farinae (Der F), Short Ragweed, Timothy grass, egg, milk and peanut. Specific IgE was measured for these same allergens and total IgE was determined. Results African American children (n = 466) were more likely than White children (n = 223) to have experienced any of the outcomes examined: at least 1 positive skin prick test from the panel of 10 allergens (21.7{\%} vs. 11.0{\%}, P = 0.001); at least one specific IgE ≥ 0.35 IU/mL (out of a panel of 10 allergens) (54.0{\%} vs. 42.9{\%}, P = 0.02); had AD (27.0{\%} vs. 13.5{\%}, Chi-square P < 0.001); and to ever have wheezed (44.9{\%} vs. 36.0{\%}, P = 0.03). African American children also tended to have higher total IgE (geometric means 23.4 IU/mL (95{\%}CI 20.8, 27.6) vs. 16.7 IU/mL (95{\%}CI 13.6, 20.6 IU/mL), Wilcoxon Rank Sum P = 0.004). With the exception of wheezing, the associations did not vary after adjusting for common social economic status variables (e.g. household income), environmental variables (endotoxin; dog, cat and cockroach allergen in house dust) or variables that differed between the racial groups (e.g. breastfeeding). After adjustment, the wheeze difference was ameliorated. Conclusions With disparities emerging as early as age 2 years, investigations into sources of the disparities should include the prenatal period and early life.",
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AU - Havstad, S.

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AU - Woodcroft, K.

AU - Johnson, C. C.

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N2 - Background Racial disparities in allergic disease outcomes have been reported with African Americans suffering disproportionately compared to White individuals. Objective To examine whether or not racial disparities are present as early as age 2 years in a racially diverse birth cohort in the Detroit metropolitan area. Methods All children who were participants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physician exam with skin prick testing and parental interview at age 2 years. Physicians made inquiries regarding wheezing and allergy symptoms and inspected for and graded any atopic dermatitis (AD). Skin testing was performed for Alternaria, cat, cockroach, dog, Dermatophagoides farinae (Der F), Short Ragweed, Timothy grass, egg, milk and peanut. Specific IgE was measured for these same allergens and total IgE was determined. Results African American children (n = 466) were more likely than White children (n = 223) to have experienced any of the outcomes examined: at least 1 positive skin prick test from the panel of 10 allergens (21.7% vs. 11.0%, P = 0.001); at least one specific IgE ≥ 0.35 IU/mL (out of a panel of 10 allergens) (54.0% vs. 42.9%, P = 0.02); had AD (27.0% vs. 13.5%, Chi-square P < 0.001); and to ever have wheezed (44.9% vs. 36.0%, P = 0.03). African American children also tended to have higher total IgE (geometric means 23.4 IU/mL (95%CI 20.8, 27.6) vs. 16.7 IU/mL (95%CI 13.6, 20.6 IU/mL), Wilcoxon Rank Sum P = 0.004). With the exception of wheezing, the associations did not vary after adjusting for common social economic status variables (e.g. household income), environmental variables (endotoxin; dog, cat and cockroach allergen in house dust) or variables that differed between the racial groups (e.g. breastfeeding). After adjustment, the wheeze difference was ameliorated. Conclusions With disparities emerging as early as age 2 years, investigations into sources of the disparities should include the prenatal period and early life.

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