Disparity in the Availability of Injectable Epinephrine in a Large, Diverse US School District
Disparity in the Availability of Injectable Epinephrine in a Large, Diverse US School District
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DOI：
10.1016/j.jaip.2013.09.016
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发表时间：
2014-05-01
影响因子：
9.4
通讯作者：
Davis, Carla M.
中科院分区：
文献类型：
--
作者：
Shah, Sweta S.;Parker, Crystal L.;Davis, Carla M.
背景：食物过敏影响2.5%的美国人口。研究结果表明，少数民族对食物过敏的患病率最高。休斯顿独立学区(HISD)有一个城市，社会经济多元化的人口，种族和社会经济地位(SES)与肾上腺素可获得性之间的关系在这一人群中尚未被探索。目的：本研究试图了解SES和肾上腺素在城市学校中的存在之间的联系。方法：通过电子邮件向HISD每所小学的一名护士发送一份关于食物过敏特征的6项问卷，以确定食物过敏反应的数量、特征和治疗，以及肾上腺素注射器的存在。对上一学年的反应和注射器的存在进行了评估。根据全国学校午餐计划的学生参与度，学校根据社会经济变量被归类为“低”或“非低”。结果：97%的学校报告有一名或多名儿童对食物过敏，但只有43%的学校报告有肾上腺素注射器。学校注射注射器的数量与较高社会经济地位的学生有关(r(2)=0.701；P<；.001)。非低社会地位学校的注射器数量是低社会地位学校的6倍(P<；.03)。结论：在HISD中，非低SES学校比低SES学校更容易发现肾上腺素注射器。由于少数族裔学生在低SES学校的比例不成比例地高，因此HISD学校的少数族裔学生在注射肾上腺素方面似乎存在差距。(C)2013年美国过敏、哮喘和免疫学学会
BACKGROUND: Food allergies affect 2.5% of the US population. Results of studies show that minorities have the highest prevalence of food allergies. The Houston Independent School District (HISD) has an urban, socioeconomically diverse population and the role of ethnicity and socioeconomic status (SES) with availability of epinephrine has not been explored in this population.OBJECTIVE: This study sought to understand the association of SES and the presence of epinephrine in urban schools.METHODS: A 6-item questionnaire about food allergy characteristics was sent by e-mail to one nurse per elementary school in the HISD to identify the number, characteristics and treatment of food allergic reactions, and the presence of epinephrine injectors. The reactions and presence of injectors were assessed for the previous school year. Schools were categorized by socioeconomic variables as "low" or "non-low" based on National School Lunch Program student participation. Poisson, logistic, and linear regression analyses were used for group comparisons.RESULTS: One or more children with food allergies were reported in 97% of responding schools, but only 43% of schools reported having epinephrine injectors. A larger number of injectors in schools were associated with students of higher SES (r(2) = 0.701; P < .001). There were 6 times more injectors in non-low SES schools than in low SES schools (P < .03). Low SES and limited English proficiency were associated with decreased epinephrine injectors in schools.CONCLUSION: In the HISD, epinephrine injectors were more likely to be found in non-low SES schools versus low SES schools. Because minority students are disproportionately highly represented in low SES schools, there appears to be a disparity in the availability of injectable epinephrine for minority students in HISD schools. (C) 2013 American Academy of Allergy, Asthma & Immunology