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  • Jefferson Adams
    Jefferson Adams

    Poorer Celiac Kids More Likely to Remain Undiagnosed

    Reviewed and edited by a celiac disease expert.

    Caption: Photo: CC--Stig Nygaard

    Celiac.com 03/09/2015 - When you hear estimates saying that celiac disease has a prevalence of about 1% of then general population of a given place, it is important to remember that there are still significant variations in rates of certain subgroups within those general populations.

    Photo: CC--Stig NygaardThat is illustrated by a a recent UK study that shows that poor UK children with celiac disease are far more likely to remain undiagnosed, compared their non-poor counterparts. In fact, rich and middle-class children are 80% more likely to receive proper medical diagnosis for celiac disease, compared to poor children, according to results from a recent UK study.

    So even though serological studies indicate that celiac disease affects about 1% of all UK children, current estimates of diagnostic patterns among children do not indicate how disease rates might vary by socioeconomic group.

    A research team in the UK recently looked into socioeconomic variation in the incidence of childhood celiac disease. The research team included Fabiana Zingone, Joe West, Colin J. Crooks, Kate M. Fleming, Timothy R. Card, Carolina Ciacci, Laila J. Tata. They are variously affiliated with the Division of Epidemiology and Public Health, City Hospital Campus of University of Nottingham in Nottingham, UK, and the Department of Medicine and Surgery at the University of Salerno in Salerno, Italy.

    For their study, the team identified all children aged 0–18 years between 1993 and 2012 treated by general practices nationwide that are part of a large population-based patient health database.

    They assessed the incidence of celiac disease in each quintile of the Townsend index of deprivation and stratified by age, sex, country and calendar year.

    From information on 2,063,421 children, they found 1,247 celiac disease diagnoses, for an overall celiac rate of 11.9 per 100 000 person-years, which was similar across the UK countries, and higher in girls than in boys.

    Interestingly, they found a range of celiac diagnosis across socioeconomic groups, with the rate of diagnosis being 80% higher in children from the least-deprived areas than in those from the most-deprived areas (incident rate ratio 1.80, 95% CI 1.45 to 2.22). This pattern held for both boys and girls and across all ages.

    Across all four countries of the UK, they found similar associations between celiac disease and socioeconomic status. While celiac incidence up to age 2 remained stable over the study period, diagnoses at older ages have almost tripled over the past 20 years.

    Children living in less socioeconomically deprived areas in the UK are more likely to be diagnosed with celiac disease. Increased implementation of diagnostic guidelines could result in better case identification in more-deprived areas.

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    The most serious omission in this article is no identification of the DIAGNOSIS TESTS! The proper education to any income group is not a problem of affordability!... Education can even point out that a simple illumination of GLUTEN, MAY be an adequate test!

    There are widespread fallacies concerning such gluten-free testing, in both diet expense and affect issues.... making this article seriously inadequate.

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    It should be the same in United States; the less educated you are, the less probability you have to get a good job with good insurance. I say for the Hispanic population i.e., from which 8% is estimated to have celiac disease, there is a great deal of ignorance because doctors and authorities do not educate Hispanics about celiac disease or do not think that Hispanic population may have the disease or because they were not told in the Medical School that Hispanics have also the disease or simply because of racism.

    The author of this summary does not discuss why

    poor children have less chance to be diagnosed; I assume that the authors of the study did (we have an idea why but the study is incomplete without this kind of discussion).

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    The most serious omission in this article is no identification of the DIAGNOSIS TESTS! The proper education to any income group is not a problem of affordability!... Education can even point out that a simple illumination of GLUTEN, MAY be an adequate test!

    There are widespread fallacies concerning such gluten-free testing, in both diet expense and affect issues.... making this article seriously inadequate.

    "Education can even point out that a simple illumination of GLUTEN, MAY be an adequate test!" Illumination? Do you mean "elimination?"

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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