Racial Disparities in Incidence of Diaper Dermatitis and Implications for Diaper Inequities

Objectives: To examine if the likelihood of infants and toddlers requiring medical care for diaper dermatitis, a condition linked to infrequent diaper changes and possible diaper need, is different across racial/ethnic groups. Materials/Methods: This is a population-based retrospective study. We collected data via public records requests from the California Department of Health Care Access and Information to determine the number of patients aged 0 to 3 years diagnosed with diaper dermatitis from 2010 to 2021 in emergency departments (EDs) and hospitals. We used two sample t-tests to compare the incidences of ED visits and in-patient hospitalization during the 11-year time period to identify differences across racial/ethnic groups. Results: From 2010 to 2021, there were 184,097 total diagnoses of diaper dermatitis, 53,678 of which received in-patient treatment. The annual mean was 15,341 and ranged between 9,407 and 17,425. The prevalence (per 1,000 children aged 0-5 of the respective race) was highest for the Black population averaging 9.56 (range: 5.79 to 11.37). The prevalence was 5.93 (3.75 to 7) for the White population, 2.49 (1.78 to 3.14) for Asian/Pacific Islanders, and 6.67 (4.25 to 7.52) for the Hispanic population. We find that Black children were disproportionately diagnosed with diaper dermatitis in California hospitals and EDs (p < 0.001). Conclusions: Racial disparities in medical conditions that can result from lack of sufficient diapers point to diaper need as a social determinant of health deserving of greater public attention and policy redress.