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Ann Allergy Asthma Immunol. 2019 Feb;122(2):198-203.e3. doi: 10.1016/j.anai.2018.10.022. Epub 2018 Oct 27.

Associations of unsafe, unsupportive, and underdeveloped neighborhoods with atopic dermatitis in US children.

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Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois. Electronic address:



Atopic dermatitis (AD) is influenced by multiple emotional and environmental factors. Yet, little is known about the impact of neighborhood environment characteristics on AD.


To determine the association of neighborhood characteristics with AD prevalence and severity in US children.


We analyzed data from the 2007-2008 National Survey of Children's Health, including a representative sample of 79,667 children and adolescents (age 0-17 years) in the United States. Multivariable weighted logistic regression models that adjusted for sociodemographics were constructed to determine the associations of neighborhood characteristics with AD prevalence and severity.


Atopic dermatitis prevalence or severity were significantly increased in children residing in neighborhoods where people reportedly definitely do not help each other out (adjusted odds ratio [95% confidence interval]: 1.32 [1.15-1.52]), watch out for each other's children (1.26 [1.10-1.45] and 1.66 [1.14-2.41], respectively), have people to count on (1.28 [1.13-1.45]), and trusted adults to help the child (1.16 [1.01-1.32] and 1.54 [1.05-2.27], respectively). Children also had increased odds of AD if their caregiver felt that the child was never (1.52 [1.27-1.82]) or sometimes (1.23 [1.12-1.36]) safe in his/her neighborhood. Severe AD was less common in children residing in a neighborhood with a bookmobile or library (0.68 [0.52-0.90]).


US children residing in unsafe, unsupportive, or underdeveloped neighborhoods have higher prevalence and severity of AD.


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