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      Racial Disparities in Allergic Outcomes in African Americans Emerge as Early as Age 2 Years

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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

          Examine whether 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% versus 11.0%, p=0.001); at least one specific IgE ≥0.35 IU/mL (out of a panel of 10 allergens) (54.0% versus 42.9%, p=0.02); had AD (27.0% versus 13.5%, Chi-square p<0.001); and to ever have wheezed (44.9% versus 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) versus 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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          Author and article information

          Journal
          8906443
          2701
          Clin Exp Allergy
          Clin. Exp. Allergy
          Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
          0954-7894
          1365-2222
          20 December 2011
          June 2012
          01 June 2013
          : 42
          : 6
          : 909-917
          Affiliations
          [1 ]Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI
          [2 ]Division of Allergy and Clinical Immunology, Henry Ford Hospital, Detroit, MI
          [3 ]Department of Pediatrics, Georgia Health Sciences University, Augusta, GA
          Author notes
          Corresponding author: Ganesa Wegienka, 1 Ford Place, 3E, Detroit, MI, 48202, Phone: 313-874-3566, Fax: 313-874-6730, gwegien1@ 123456hfhs.org
          Article
          PMC3428737 PMC3428737 3428737 nihpa345128
          10.1111/j.1365-2222.2011.03946.x
          3428737
          22909162
          ba9fb9aa-f3c0-4fe3-9d75-73617c7a6b0a
          History
          Funding
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: R01 AI050681-05 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: R01 AI050681-04 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: R01 AI050681-03 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: R01 AI050681-02 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: R01 AI050681-01A1 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: K01 AI070606-04 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: K01 AI070606-03 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: K01 AI070606-02 || AI
          Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
          Award ID: K01 AI070606-01A2 || AI
          Categories
          Article

          allergic disease,racial disparities,IgE,atopy
          allergic disease, racial disparities, IgE, atopy

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