Advancing equity in allergy and immunology: progress, pitfalls, and the path forward

TL;DR

This paper reviews health disparities in allergy and immunology, highlighting how social factors affect marginalized groups and what interventions can help reduce these gaps.

Contribution

The paper provides a comprehensive review of disparities in allergic and immunologic conditions and evaluates interventions to promote equity.

Findings

Marginalized populations face delayed diagnoses and limited access to specialist care for allergic and immunologic conditions.

Community health worker outreach and policy reforms have shown success in addressing health inequities.

Recent funding cuts threaten progress in public health infrastructure for equitable care.

Abstract

Health disparities in allergic and immunologic conditions are shaped by unequal exposure to social determinants of health (SDoH), including education, healthcare quality, neighborhood and built environment, social context, and economic stability. This review summarizes recent literature on disparities across asthma, food allergy, eosinophilic esophagitis, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, drug allergy, and primary immunodeficiency. Marginalized populations—including Black, Latinx, and low-income individuals—experience delayed diagnoses, limited access to specialist care, underuse of evidence-based therapies, and disproportionate exposure to environmental triggers. The manuscript highlights successful interventions including community health worker–led outreach, school-based programs, housing modifications, and policy reforms addressing affordability, housing, and environmental quality. However, recent cuts to federal agency staffing and funding jeopardize continued progress, threatening public health infrastructure that supports equitable care for many diseases. Sustained investment, interdisciplinary collaboration, and policy-driven strategies remain critical to addressing persistent inequities and improving outcomes in historically underserved communities.

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