Utilization of Preventive Health Care in Adults and Children With Eczema

Abstract

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.