Allergic Rhinitis—Underrepresented Populations and Barriers to Healthcare Access

Peifer, S.J., Helmen, Z.M., Duffield, S., Shields, C., Mehra, S., Lerner, D.K. and Gadkaree, S.K. (2025), The Laryngoscope. https://doi.org/10.1002/lary.32165

ABSTRACT

Objective

To establish the prevalence of allergic rhinitis (AR), categorized by demographics and barriers to healthcare, and the prevalence of antihistamine and nasal steroid use in these subgroups.

Methods

We performed a retrospective, cross-sectional study utilizing the All of Us Database. Sociodemographic factors among AR patients were compared via Chi-Square analysis and multivariable logistic regression (MLR). Subgroups of AR patients with or without nasal steroid spray or oral antihistamine listed in the electronic health record (EHR) were compared via chi-square analysis and MLR.

Results

Demographic description of all patients vs. allergic rhinitis patients (AR)
in the All of Us database

47,224 participants were identified with AR, an 11.6% estimated prevalence. AR patients were more commonly White (12.8% vs. 10.6%, p < 0.001), female (13.1% vs. 9.1%, p < 0.001), and older than 65 (14.7% vs. 7.6% vs. 11.6%, p < 0.001). MLR identified older age (OR 1.018, CI: 1.017–1.018), income > $35,000 (OR 1.035, CI: 1.021–1.049), finishing high school/college (OR 1.140, CI: 1.113–1.167; OR 1.113, CI: 1.085, 1.142), and health insurance coverage (OR 2.003, CI: 1.924–2.087) as predictive factors for AR.

Patients with nasal steroid spray and/or oral antihistamine listed in the EHR were more commonly Black (OR 1.250, CI: 1.177–1.328; OR 1.491, CI: 1.398–1.590) and had an income < $35,000 (OR 0.856, CI: 0.814–0.900; OR 0.724, CI: 0.687–0.764).

Conclusion

AR patients were more likely to be insured, while oral antihistamines/nasal steroid spray listed in the EHR were associated with lower income and Black race. These results highlight the barriers to AR diagnoses and treatment and the need for providers to ensure that underserved patients are offered appropriate care.

Level of Evidence

3

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