Black Children Miss Seeing Doctor for Eczema Despite Severe Effects

Black children have more severe cases of eczema than white children but are less likely to see a doctor for this skin condition, a new study has found.

Researchers from Penn Medicine reported last week in the Journal of the American Academy of Dermatology that black children with eczema were 30% less likely to see a doctor for eczema than white children, based on an analysis of 12 years’ worth of data from the Medical Expenditure Panel Survey (MEPS).

The researchers collected data from 2043 people with eczema and estimated their findings on a national scale. Based on these calculations, 3 million children in the United States have eczema; 66% are white, 18% are black, and 16% are Hispanic. About 60% of the children have seen a doctor for the condition, but the percentages by race vary: 62.1% of white children saw a doctor, and 58.1% of Hispanic children did. Among black children, the share was just 51.9%, after accounting for socioeconomic differences and insurance status.

“This translates to a 30% lower likelihood of seeing a doctor for their eczema than whites,” the authors said in a statement.

Factoring in insurance status and income causes authors to reach a harsh conclusion, according to Junko Takeshita, MD, PhD, MSCE, senior author and an assistant professor of Dermatology and Epidemiology at Penn. “The data show that race alone can be a predictor of whether or not a child with eczema will see a doctor,” Takeshita said.

There are several forms of eczema; the most common is called atopic dermatitis and causes the skin to appear red and to itch. It is an inflammatory condition that affects between 10% and 20% of infants and about 3% of adults. While the condition primarily affects the skin, it can cause psychological effects when it cannot be controlled.

Black children were less likely to see a doctor for the condition, even though the study also found that when these children did see a doctor they had more visits and received more prescriptions to treat the condition than white children, indicating they had more severe disease. This would be consistent with data from CDC that show higher rates of eczema among black children (17.1%) than white children (11.2%) or Hispanic children (13.7%).

“Previous studies have demonstrated disparities in overall healthcare utilization among racial and ethnic minorities, but few studies have examined this question specifically for eczema,” Takeshita said. “This is the first study to look at racial and ethnic differences in healthcare utilization for eczema on and 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 their disease.”

The MEPS data are representative of the national population and are based on self- or caregiver reports over a series of interviews.