Jonathan I Silverberg1, Eric L Simpson. 1. From the Departments of *Dermatology, †Preventive Medicine, and ‡Medical Social Sciences, Northwestern University, Chicago, IL; and §Department of Dermatology, Oregon Health and Sciences University, Portland, OR.
Abstract
BACKGROUND: Little is known about the predictors of eczema severity in the US population. OBJECTIVES: We sought to determine the distribution and associations of childhood eczema severity in the United States. METHODS: We analyzed the data from the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children (range, 0-17 years). RESULTS: The prevalence of childhood eczema was 12.97% (95% confidence interval [95% CI], 12.42-13.53); 67.0% (95% CI, 64.8-69.2) had mild disease, 26.0% (95% CI, 23.9-28.1) had moderate disease, and 7.0% (95% CI, 5.8-8.3) had severe disease. There was significant statewide variation of the distribution of eczema severity (Rao-Scott χ, P = 0.004), with highest rates of severe disease in Mid-Atlantic and Midwestern states. In univariate models, eczema severity was increased with older age, African American and Hispanic race/ethnicity, lower household income, oldest child in the family, home with a single mother, lower paternal/maternal education level, maternal general health, maternal/paternal emotional health, dilapidated housing, and garbage on the streets. In multivariate survey logistic regression models using stepwise and backward selection, moderate-to-severe eczema was associated with older age, lower household income, and fair or poor maternal health but inversely associated with birthplace outside the United States. CONCLUSIONS: These data indicate that environmental and/or lifestyle factors play an important role in eczema severity.
BACKGROUND: Little is known about the predictors of eczema severity in the US population. OBJECTIVES: We sought to determine the distribution and associations of childhood eczema severity in the United States. METHODS: We analyzed the data from the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children (range, 0-17 years). RESULTS: The prevalence of childhood eczema was 12.97% (95% confidence interval [95% CI], 12.42-13.53); 67.0% (95% CI, 64.8-69.2) had mild disease, 26.0% (95% CI, 23.9-28.1) had moderate disease, and 7.0% (95% CI, 5.8-8.3) had severe disease. There was significant statewide variation of the distribution of eczema severity (Rao-Scott χ, P = 0.004), with highest rates of severe disease in Mid-Atlantic and Midwestern states. In univariate models, eczema severity was increased with older age, African American and Hispanic race/ethnicity, lower household income, oldest child in the family, home with a single mother, lower paternal/maternal education level, maternal general health, maternal/paternal emotional health, dilapidated housing, and garbage on the streets. In multivariate survey logistic regression models using stepwise and backward selection, moderate-to-severe eczema was associated with older age, lower household income, and fair or poor maternal health but inversely associated with birthplace outside the United States. CONCLUSIONS: These data indicate that environmental and/or lifestyle factors play an important role in eczema severity.
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Authors: Mahboobeh Mahdavinia; Susan R Fox; Bridget M Smith; Christine James; Erica L Palmisano; Aisha Mohammed; Zeeshan Zahid; Amal H Assa'ad; Mary C Tobin; Ruchi S Gupta Journal: J Allergy Clin Immunol Pract Date: 2016-11-23
Authors: J I Silverberg; N Patel; S Immaneni; B Rusniak; N B Silverberg; R Debashis; N Fewkes; E L Simpson Journal: Br J Dermatol Date: 2015-10-23 Impact factor: 9.302