Asthma, which affects a greater number of minority and socially disadvantaged children, is often associated with greater exposure to indoor and outdoor allergens. A new study shows for the first time that racial differences in indoor allergen sensitivity are consistent with racial differences in asthma-related illness and are especially marked in inner cities. The researchers found that disadvantaged black and Mexican-American children had greater exposure to the indoor allergens—dust mite, cockroach, and the common fungus, Alternaria alternata—than white children. These allergens have been linked to increased problems with asthma, and A. alternata, which is more likely in homes with interior water leaks, has been linked to increased risk of death from asthma.
Racial disparities in exposure to environmental factors in housing and/or the community may play a role in determining national patterns of asthma-related illness, concludes Peter J. Gergen, M.D., M.P.H., of the Agency for Healthcare Research and Quality. Dr. Gergen and his colleagues suggest that national public health and housing policies are needed to reduce allergen exposure among children, especially in minority communities. They analyzed results of allergen testing of a representative sample of 4,164 U.S. children aged 6 to 16 years between 1988 and 1994 as part of the Third National Health and Nutrition Examination Survey. They analyzed skin prick reactions to cat, cockroach, dust mite, and A. alternata.
Black children had more than twice and Mexican-American children had nearly twice the odds of cockroach sensitivity as white children. Racial disparities in cockroach sensitivity were strongest in the inner city as well as in crowded households (2.5 or more people per room). Compared with white children, both black and Mexican-American children had higher odds of dust mite sensitivity, and black children had twice the odds of A. alternata sensitivity. Race was not associated with cat sensitivity, but there was a lower prevalence of cat sensitivity among children in low-income households.
See "Sociodemographic correlates of indoor allergen sensitivity among United States children," by Lori A. Stevenson, M.P.H., Dr. Gergen, Donald R. Hoover, Ph.D., M.P.H., in the November 2001 Journal of Allergy and Clinical Immunology 108, pp. 747-752.
Reprints (AHRQ Publication No. 02-R043) are available from the AHRQ Publications Clearinghouse and AHRQ InstantFax.