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Utilization of Preventive Health Care in Adults and Children With Eczema

  • Mark A. Strom
    Affiliations
    Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
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  • Jonathan I. Silverberg
    Correspondence
    Address correspondence to: Jonathan I. Silverberg, MD, PhD, MPH, Northwestern University Feinberg School of Medicine, Department of Dermatology, Suite 1600, 676 N. St Clair St., Chicago IL 60611.
    Affiliations
    Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois

    Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois
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Published:November 04, 2015DOI:https://doi.org/10.1016/j.amepre.2015.07.029

      Introduction

      Chronic disease is a barrier to delivery of preventive health care and health maintenance. However, health behaviors of adults and children with eczema, a chronic skin disorder, have not been examined. This study examined associations of eczema with vaccination, disease screening, health maintenance, and healthcare utilization.

      Methods

      This study investigated 34,613 adults and 13,298 children from the 2012 National Health Interview Survey, a prospective questionnaire-based study. Data were analyzed between August 2014 and January 2015.

      Results

      Adult eczema was associated with higher odds of vaccination for tetanus (OR [95% CI]=1.37 [1.22, 1.54]); influenza (1.23 [1.10, 1.37]); hepatitis A (1.21 [1.04, 1.41]) and B (1.21 [1.07, 1.35]); human papilloma virus (1.66 [1.32, 2.08]); and pneumonia (1.35 [1.19, 1.54]), but not herpes zoster virus (1.07 [0.87, 1.31]). Adult eczema was associated with increased measurement of blood glucose (1.29 [1.16, 1.44]); cholesterol (1.19 [1.06, 1.34]); blood pressure (1.84 [1.56, 2.08]); and HIV infection (1.50 [1.34, 1.70]), but not Pap smears (1.11 [0.95, 1.30]); colon cancer screening (p=0.17); or mammograms (p=0.63). Adults with eczema were more likely to interact with general doctors, mid-level providers, mental health professionals, eye doctors, podiatrists, chiropractors, therapists, obstetrician/gynecologists, and other specialists (p≤0.01). Childhood eczema was associated with higher rates of vaccination for influenza (p<0.0002); well child checkups (p=0.002); and interaction with most types of healthcare providers (p≤0.01). Many associations remained significant in multivariate models controlling for sociodemographics and healthcare interaction frequency.

      Conclusions

      Eczema in adults and children is associated with greater utilization of preventive health care and health maintenance, but not cancer screening.
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