J Allergy Clin Immunol. 2023 Oct 4:S0091-6749(23)01248-4. doi: 10.1016/j.jaci.2023.09.036. Online ahead of print.
ABSTRACT
BACKGROUND: Racial and ethnic disparities in life expectancy in the U.S. have been widely documented. To date, there remains a paucity of similar data in patients with inborn errors of immunity (IEI).
OBJECTIVE: To examine racial and ethnic differences in IEI mortality in the U.S.
METHODS: We analyzed the National Center for Health Statistics national mortality data from 2013 to 2018. We quantified age-adjusted death rate (ADR) and age-specific death rate (ASDR) from IEI for each major racial and ethnic group in the U.S, and examined the association of race and ethnicity with death at a younger age. For detailed Methods, please see the Methods section in this article’s Online Repository at www.jacionline.org.
RESULTS: During 2003 to 2018, IEI was reported as the underlying or contributing cause of death in 14,970 individuals nationwide. ADR was highest among Black patients (4.25 per 1,000,000 person-years), compared with 2.01, 1.71, 1.50, and 0.92 per 1,000,000 person-years for White, American Indian/Alaska Native (AIAN), Hispanic, and Asian/Pacific Islander (API) patients, respectively. Odds of death before age 65 years was greatest among Black patients (OR 5.15; 95% CI 4.61-5.76), followed by AIAN patients (OR 3.58; 95% CI 2.30-5.82), compared with White patients. Odds of death before age 24 years was greatest among Hispanic patients, compared with non-Hispanic patients (OR 3.60; 95% CI 3.08-4.18).
CONCLUSION: Our study highlights racial and ethnic disparities in IEI mortality and the urgent need to further identify and systematically remove barriers in care for historically marginalized patients with IEI.
PMID:37802474 | DOI:10.1016/j.jaci.2023.09.036
