Sociodemographic correlates of indoor allergen sensitivity among United States children

Background: Exposure to indoor allergens is associated with asthma morbidit y. Nationally, asthma morbidity disproportionately affects socially disadva ntaged populations, but it is unclear whether exposure to indoor allergens follows a similar pattern. Objective: We sought to examine the national prevalences and demographic co rrelates of sensitivity to indoor allergens related to asthma. Methods: Analysis of a cross-sectional survey of a representative sample of 4164 United States children aged 6 to 16 years who participated in allerge n testing in the Third National Health and Nutrition Examination Survey fro m 1988 to 1994 was performed. The main outcome measures were sensitivity re actions to cockroach, dust mite, cat, and Alternaria alternata, as measured via skin prick testing. Results: Multivariate models, including sex, age, race-ethnicity, education , poverty, family history, region of country, housing age, crowding, and ur ban residence, revealed significant racial-ethnic disparities in sensitivit y. Compared with white children, African American children had higher odds ratios (ORs) of cockroach or dust mite sensitivity (cockroach,. [95% Cl, 1. 9-3.2]; dust mite OR, 1.3 [95% CI, 1.0-1.7]), as did Mexican American child ren (cockroach OR, 1.9 [95% CI, 1.3-2.8]; dust mite OR, 1.6 [95% C1, 1.2-2. 2]). African American children also had significantly higher odds of sensit ivity to A alternata (OR, 2.1 [95% CI, 1.5-2.8]). Conclusions: African American and Mexican American children are substantial ly more likely than white children to be sensitized to allergens important in asthma. Differences in indoor allergen sensitivity are consistent with r acial differences in asthma morbidity. Along with other data, these finding s suggest that racial disparities in housing, community, or both environmen tal factors play a role in determining national patterns of asthma morbidit y.