Burden of allergic disease among ethnic minority groups in high-income countries.

Christina J Jones, Priyamvada Paudyal, Robert M West, Adel H Mansur, Nicola Jay, Nick Makwana, Sarah Baker, Mamidipudi T Krishna

Journal: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2022;52(5):604-615

PMID: 35306712

Abstract

The COVID-19 pandemic raised acute awareness regarding inequities and inequalities and poor clinical outcomes amongst ethnic minority groups. Studies carried out in North America, the UK and Australia have shown a relatively high burden of asthma and allergies amongst ethnic minority groups. The precise reasons underpinning the high disease burden are not well understood, but it is likely that this involves complex gene-environment interaction, behavioural and cultural elements. Poor clinical outcomes have been related to multiple factors including access to health care, engagement with healthcare professionals and concordance with advice which are affected by deprivation, literacy, cultural norms and health beliefs. It is unclear at present if allergic conditions are intrinsically more severe amongst patients from ethnic minority groups. Most evidence shaping our understanding of disease pathogenesis and clinical management is biased towards data generated from white population resident in high-income countries. In conjunction with standards of care, it is prudent that a multi-pronged approach towards provision of composite, culturally tailored, supportive interventions targeting demographic variables at the individual level is needed, but this requires further research and validation. In this narrative review, we provide an overview of epidemiology, sensitization patterns, poor clinical outcomes and possible factors underpinning these observations and highlight priority areas for research.

© 2022 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

Address: School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK.; Department of Primary Care & Public Health, Brighton & Sussex Medical School, Brighton, UK.; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.; Birmingham Regional Severe Asthma Service, University Hospitals Birmingham NHS Foundation Trust, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.; Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.; Department of Child Health, Sandwell and West Birmingham Hospitals, Birmingham, UK.; Anaphylaxis Campaign, Farnborough, UK.; Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
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