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Research Letter
May 22, 2019

Racial and Ethnic Differences in Atopic Dermatitis–Related School Absences Among US Children

Author Affiliations
  • 1Department of Dermatology, Perelman School of Medicine,University of Pennsylvania, Philadelphia
  • 2Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA Dermatol. Published online May 22, 2019. doi:10.1001/jamadermatol.2019.0597

Atopic dermatitis (AD) affects up to 20% of children and is more common among black children.1 An association of AD with school absenteeism has been suggested.2 In this cross-sectional study, we examined AD-related school absences by race/ethnicity.

We used baseline data from children enrolled into the US-based Pediatric Eczema Elective Registry (PEER) between November 25, 2004, and July 18, 2017. All children were aged 2 to 17 years and had a physician-confirmed AD diagnosis. Details of PEER have been previously reported.3 On registry enrollment, children or their caregivers completed a questionnaire collecting information about demographic characteristics, medical conditions, AD history and treatment, and number of school days missed owing to AD (0, 1-5, 6-10, or >10) in the preceding 6-month period. Atopic dermatitis control in the same 6-month period was also reported by the child or caregiver as complete, good, limited, or uncontrolled. In this study, self-reported race/ethnicity, categorized as non-Hispanic white, non-Hispanic black, Hispanic, or other, was the primary explanatory variable. The primary outcome was reporting of 6 or more school days missed owing to AD in the previous 6 months, which approximates the US Department of Education’s definition of chronic school absenteeism. The association between race/ethnicity and at least 6 school absences was assessed using logistic regression, adjusting for sociodemographic factors, AD control, comorbid atopic disorders, and health care utilization. Children not enrolled in school or day care were excluded. Caregivers for participants in PEER provided informed consent; the present analysis was granted exempt status by the University of Pennsylvania Institutional Review Board owing to the use of deidentified data.

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