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Hispanic and black children more likely to miss school due to eczema than white children

May 22, 2019

PHILADELPHIA - In a study that highlights racial disparities in the everyday impact of eczema, new research shows Hispanic and black children are more likely than white children to miss school due to the chronic skin disease. Researchers from the Perelman School of Medicine at the University of Pennsylvania examined more than a decade's-worth of data among children enrolled in a national eczema registry and found Hispanic children were most likely to have missed at least six days of school over six-month period due to their condition. Black children also saw higher probabilities of missed school days compared to white children. JAMA Dermatology published the findings today.

Eczema, or atopic dermatitis (AD), is a common inflammatory disease that causes red and itchy skin. It affects about 30 million Americans in total, including up to 20 percent of children in the United States, according to the Centers for Disease Control. It is more common among black children and slightly more common in Hispanic children when compared with whites. In addition to the physical impact, eczema is associated with negative psychological effects, including an increased likelihood of anxiety and depression.

"The effects of eczema are more than skin-deep, and studies have shown that the mental health and social impact of this condition can be significant - sometimes just as much or more than the physical - and may lead to a higher number of school days missed," said the study's lead author Joy Wan, MD, MSCE, a post-doctoral fellow and Instructor of Dermatology.

Building on that previous research, this study specifically looked at eczema-related school absenteeism by race and ethnicity. Researchers used data on 8,015 patients enrolled in the Pediatric Eczema Elective Registry (PEER) between November 2004 and July 2017. All patients were between the ages of 2 and 17 and had their AD diagnosed by a doctor. Overall, 241 of them (3.3 percent) missed six or more days of school over a six-month period, which meets the U.S. Department of Education's definition of chronic school absenteeism. When adjusted for demographic and other variables, data showed Hispanic children were 3.4 times more likely to be chronically absent due to AD than white children. Black children were 1.5 times more likely.

The PEER data are self-reported, and the authors say the children included in PEER may not represent the general population with eczema. They say more research is needed to better understand the link. However, they point out this adds to a growing body of work that uncovers disparities related to eczema, including their recent study showing black and Hispanic children are more likely to go to an emergency room and black children are less likely to see a dermatologist for their eczema than white children.

"Most people don't realize the serious impact eczema can have on a person's life, and our research shows minorities may be disproportionately affected," said the study's senior author Junko Takeshita, MD, PhD, MSCE, an assistant professor of Dermatology and Epidemiology. "We still have a lot to learn about eczema-related disparities but it's becoming increasingly clear that these disparities need to be addressed."
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This study was supported by National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23-AR068433, T32-AR007465, R01-AR069062, R01-AR070873), and a Dermatology Foundation Dermatologist Investigator Research Fellowship. While PEER is a study funded by Valeant Pharmaceuticals, Valeant had no role in this research.

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $425 million awarded in the 2018 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center--which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report--Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation's first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Home Care and Hospice Services, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 40,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live. Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2018, Penn Medicine provided more than $525 million to benefit our community.

University of Pennsylvania School of Medicine

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