J Allergy Clin Immunol Pract. 2023 Jun 13:S2213-2198(23)00655-4. doi: 10.1016/j.jaip.2023.06.011. Online ahead of print.
ABSTRACT
BACKGROUND: Little is known regarding the impact of race, ethnicity, and socioeconomic status on the health outcomes of children with Eosinophilic esophagitis (EoE).
OBJECTIVE: To 1) identify demographic characteristics of children diagnosed with EoE in a large tertiary care center, and 2) determine associations between a patient’s demographics and depth of evaluation or treatment choices.
METHODS: This retrospective cohort study included children 0-18 years old seen in Children’s Hospital Colorado between January 1, 2009 and December 31, 2020. Demographics were extracted from the electronic medical record. Rural-Urban Commuting Area taxonomy codes were used to classify urbanization. Area Deprivation Index (ADI) scores were used to categorize neighborhood advantage/disadvantage. Data were analyzed using descriptive statistics and regression analysis.
RESULTS: The study included 2,117 children with EoE. Children with higher state ADI scores (greater neighborhood disadvantage) had less radiographic evaluation of their disease (OR (95% CI) per unit increase in state ADI = 0.93 (0.89, 0.97), p=.0002) and had esophageal dilations at younger ages (r = -0.24, p=.007). Black children when compared to White children were younger at diagnosis (8.3 versus 10.0 years, p=.002). Children from rural areas were seen less by feeding therapy (3.9% versus 9.9%, p=.02) but were younger at their visits (2.3 versus 4.3 years old, p<.001).
CONCLUSION: In this study of children with EoE cared for in a large tertiary care center, we found differences in presentation and care depending on race, urbanization, and socioeconomic status.
PMID:37321391 | DOI:10.1016/j.jaip.2023.06.011
