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Alopecia areata in underrepresented groups: preliminary analysis of the all of us research program

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Abstract

Alopecia areata (AA) is an autoimmune condition characterized by patchy, nonscarring hair loss. Few studies of AA have adequately included participants from underrepresented groups when evaluating the burden of AA in the United States. We conducted a cross-sectional study of personal/demographic factors and AA using the ongoing All of Us (AoU) Research Program. AoU enrolls adults over 18 years either as direct volunteers or through participating Health Care Provider Organizations by prioritizing recruiting underrepresented groups. We linked data from surveys and electronic health records (EHRs) to estimate the prevalence of AA by race/ethnicity, physical disability, sexual orientation/gender identity (LGBTQIA +), income, and education. The latest AoU release (version 5) includes 329,038 participants. Average age was 51.8 years (standard deviation, SD 16.7), and 60.2% of participants were female. Of these, 251,597 (76.5%) had EHR data and 752 were diagnosed with AA (prevalence, 0.30%; 95% CI 0.28–0.32). We used multivariate logistic regression adjusted for age and other factors to estimate the odds ratio (OR) and 95% confidence intervals (CIs) for prevalence of AA. Compared to Whites, Blacks and Hispanics had higher odds of AA (OR, 1.72; 95% CI 1.39–2.11 and OR, 2.13; 95% CI 1.74–2.59, respectively). Lower odds of AA were observed in participants with less than a high school degree (OR, 0.80; 95% CI 0.59–1.08), household income ≤ $35,000 (OR, 0.67; 95% CI 0.54–0.83), and no health insurance (OR 0.35; 95% CI 0.20–0.56). In this diverse population of US adults, participants with skin of color had higher prevalence of AA. Lower prevalence of AA among individuals with lower education and income levels and those lacking health insurance may reflect limited access to dermatologic care and potentially higher levels of undiagnosed AA in these groups.

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Authors and Affiliations

  1. Warren Alpert Medical School, Brown University, Box G-D, Providence, RI, 02903, USA

    Isabelle H. Moseley, Elisabeth A. George & Megan M. Tran

  2. Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Hemin Lee

  3. Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA

    Abrar A. Qureshi & Eunyoung Cho

  4. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA

    Abrar A. Qureshi & Eunyoung Cho

  5. Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Eunyoung Cho

Authors
  1. Isabelle H. Moseley
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  2. Elisabeth A. George
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  3. Megan M. Tran
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  4. Hemin Lee
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  5. Abrar A. Qureshi
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  6. Eunyoung Cho
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Contributions

IHM performed the data analysis. IHM, EAG, and MMT wrote the main manuscript text and prepared the tables. All authors edited and reviewed the manuscript.

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Correspondence to Eunyoung Cho.

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Moseley, I.H., George, E.A., Tran, M.M. et al. Alopecia areata in underrepresented groups: preliminary analysis of the all of us research program. Arch Dermatol Res 315, 1631–1637 (2023). https://doi.org/10.1007/s00403-023-02548-y

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  • DOI: https://doi.org/10.1007/s00403-023-02548-y

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