Association of specific allergen sensitization with socioeconomic factors and allergic disease in a population of Boston women

Background: Socioeconomic differences in allergic disease prevalence have b een reported; asthma has been associated with poverty in the United States and hay fever and eczema with relative affluence elsewhere. It is not yet e stablished to what degree such differences in disease prevalence reflect pa tterns of sensitization and specific allergen sensitivities. Objective: We analyzed specific and total IgE measurements in a sample of 4 58 women, enriched for allergic disease, from the metropolitan Boston area to establish the relation of allergen sensitization to markers of socioecon omic status (SES) and to the prevalence and socioeconomic pattern of allerg ic disease in this community. Methods: Total and specific IgE antibodies were measured with the UNICAP Sy stem; self-reported allergic disease, household income, education, and rate -ethnicity were ascertained with a questionnaire; and a further marker of p overty (percentage living below the poverty level) in the women's area of r esidence was established on the basis of zip codes. Analysis was performed with SAS statistical software. Results: Markers of low SES were univariately associated with increases in total IgE, number of allergen sensitizations, and levels of specific IgE, S ocioeconomic differences in sensitization to cockroach (35% vs 6% in the hi ghest and lowest poverty areas), animal (44% vs 26%) and ragweed (49% vs 23 %) allergens were most marked. Sensitization primarily to indoor inhalant a llergens (not ragweed or ryegrass) were associated with an increased risk o f asthma, even after adjustment for SES, Conclusion: We have demonstrated a socioeconomic gradient in sensitization that concords with increased rates of asthma in less affluent communities i n this population.