an itchy skin disease is more common in black children than other races but
they are less likely to see a doctor for treatment.
Pennsylvania found black children with eczema were 30 percent less likely to
see a doctor for their eczema than white children.
‘There are barriers to healthcare for eczema among black children irrespective of income and insurance status.’
The study, published in the Journal of the American
Academy of Dermatology, also found black children who
see a doctor about the condition have more visits and receive more
prescriptions than white children, indicating more severe disease.
Eczema is a common inflammatory disease that causes red and itchy skin.
There are several different types, and all told about 30 million Americans have
some form of the disease. Data from the Centers for Disease Control shows
roughly 11 percent of children experience eczema in the United States,
with black children experiencing it more commonly (17.1 percent) than white
children (11.2 percent) or Hispanic children (13.7 percent). In
addition to the physical impact on the skin, eczema is associated with negative
“Previous studies have demonstrated disparities in overall healthcare
utilization among racial and ethnic minorities, but few studies have examined
this question specifically for eczema,” said the study’s senior author
Junko Takeshita, MD, PhD, MSCE, an assistant professor of Dermatology and
Epidemiology at Penn.
“This is the first study to look
at racial and ethnic differences in healthcare utilization for eczema on an
individual level rather than relying on a sample of outpatient visits, making
this a unique evaluation of eczema that includes those not accessing care for
The study’s lead author was Alexander H. Fischer, MD, MPH, who was a medical
student at Johns Hopkins University at the time of the research.
The researchers gathered data from the Medical Expenditure Panel Survey, the
most complete source of data currently available on healthcare utilization,
cost, and insurance coverage in the United States. All of the information is
self- or caregiver-reported over a series of interviews, and is designed to be
representative of the general population. The team used information from 2001
through 2013 for Americans under the age of 18 who identified themselves as
white, black, or Hispanic. Those who identified in other groups did not make up
a large enough sample for evaluation.
Based on data collected from 2,043 people with eczema, researchers estimated
the data on a national scale. According to these estimates, of the nearly three
million children with eczema represented in this study, 66 percent are white,
18 percent are black, and 16 percent are Hispanic.
Overall, roughly 60 percent of these
children have seen a doctor for their condition, but the percentages vary by
race. Among white children, 62.1 percent saw a doctor. A similar proportion of
Hispanic children (58.1 percent) saw a doctor for their eczema.
However, the number dropped to just 51.9 percent for black children which,
after accounting for baseline differences in sociodemographic factors and
insurance status, translates to a 30 percent lower likelihood of seeing a
doctor for their eczema than whites.
“The data show that race alone can be a predictor of whether or not a
child with eczema will see a doctor, independent of other social or demographic
factors or insurance status,” Takeshita said.
In addition, minority children reporting eczema were an average of
a year to a year and a half younger. They were also less likely to have any
private insurance, more likely to fall into the low income category, and more
likely to have asthma relative to white children.
“While the study is not without its limitations, our findings suggest
there are barriers to healthcare for eczema among black children irrespective
of income and insurance status, despite likely having more severe skin
disease,” Takeshita said.
“Further research is
needed to understand what these barriers are and why they exist so that we can
ultimately make efforts to eliminate this disparity.”