Black Pediatric Patients with Hidradenitits Suppurativa Report Worse Income Status, Health Risks

Black pediatric patients with hidradenitis suppurativa (HS) are at a greater risk of living in the lowest median income level be insured by Medicaid than their non-black peers, according to new data.

In national inpatient cohort-based research presented in a poster at the American Academy of Dermatology (AAD) 2024 Annual Meeting in San Diego, CA, this week, a team of New York and New Jersey-based investigators reported that black pediatric patients with HS on average may be in a worse financial position than children of other races with the chronic skin disease. What’s more, the former group may be more predisposed to comorbidities like asthma than the latter.

Presented by Shari Lipner, MD, PhD, of the department of dermatology at Weill Cornell Medicine in New York, the team’s study sought to examine the demographic, comorbidity and outcome variables of black pediatric patients with HS via the 2016 Kids’ Inpatient Database (KID). Their analysis included 1290 total pediatric patients, of whom 586 (45.4%) were identified as black. Black patients were more likely to be older (mean age, 17.05 vs vs 16.74 years) and female (78.8% vs 67.2%; P <.001).

Lipner reported that black patients were nearly twice as likely to live in a zip code located in lowest income quartile in the US than other pediatric patients with HS (58.4% vs 33.8%; P <.001). They were additionally more likely to be insured with Medicaid (60.8% vs 56.9%; P =.009).

Despite these disparities, black patients also reported a decreased likelihood of obesity (28.8% vs 37.3%) and anxiety (8.0% vs 12.6%) compared to other patients; they additionally reported lower mean hospital charges, and had fewer mean counts of diagnoses. However, they were approximately 50% more likely to report asthma (23.7% vs 14.3%; P <.001).

In an interview with HCPLive during AAD 2024, Lipner discussed the inspiration for the trial.

“While hidradenitis typically presents in the 2nd or 3rd decades of life, it also sometimes occurs in the pediatric population—and we also know that compared to adult HS patients, pediatric HS patients have a higher percentage of claims of service at emergency departments,” Lipner said. “The other fact is that prior studies show that HS disproportionately affects black and biracial patients.”

Lipner added that, despite some limited data details in the assessment such as the lack of more substantive comorbidities, the findings warrant a greater look into the race and ethnicity-based trends of treatment capability and resource afforded to younger patients with HS.

“It does suggest, based on the data, that black patients with HS may not be getting the outpatient dermatologic care that they need, and are therefore going to the hospital with flares in their HS,” she said. “Certainly these data are very compelling and very concerning, and do point out potential health care disparities in pediatric HS patients.”

Reference

^{Singal A, Desai AD, Lipner SR. Hidradenitis Suppurativa in Black Pediatric Patients – Analysis of the Kids’ Inpatient Database. Poster presented at: American Academy of Dermatology (AAD) 2024 Annual Meeting. March 8 – 12, 2024. San Diego, CA.}