{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:54:57Z","timestamp":1789170897347,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Some previous studies have shown an increased prevalence of allergic fungal rhinosinusitis (AFRS) among young, black patients with poor access to health care; however, results have been mixed. The purpose of this study was to investigate the relationship between social determinants of health and AFRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed, Scopus, CINAHL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>A systematic review was performed searching for articles published from date\u202fof inception to September 29, 2022. English language articles describing the relationship\u202f\u202f between social determinants of health (i.e., race, insurance status) and AFRS as compared to chronic rhinosinusitis (CRS) were selected for inclusion. A Meta\u2010analysis of proportions with comparison (\u0394) of weighted proportions was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 21 articles with 1605 patients were selected for inclusion. The proportion of\u202f\u202f black patients among AFRS, chronic rhinosinusitis with nasal polyps (CRSwNP), and chronic rhinosinusitis without nasal polyps (CRSsNP) groups was 58.0% [45.3%\u201070.1%], 23.8% [14.1%\u201035.2%], and 13.0% [5.1%\u201024.0%], respectively. This was significantly higher among the AFRS population compared to both the CRSwNP population (\u039434.2% [28.4%\u201039.6%], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) and the CRSsNP population (\u039444.9% [38.4%\u201050.6%], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). The proportion of patients who were either uninsured or covered by Medicaid among the AFRS, CRSwNP, and CRSsNP populations was 31.5% [25.4%\u201038.1%], 8.6% [0.7%\u201023.8%], and 5.0% [0.3%\u201014.8%], respectively. This was significantly higher among the AFRS group than the CRSwNP group (\u039422.9% [15.3%\u201031.1%], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) and the CRSsNP group (\u039426.5% [19.1%\u201033.4%], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study confirms that AFRS patients are more likely to be Black and either uninsured or on subsidized insurance than their CRS counterparts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.396","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T06:03:20Z","timestamp":1686290600000},"page":"1101-1113","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association between Social Determinants of Health and Allergic Fungal Rhinosinusitis: A Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"169","author":[{"suffix":"III","given":"Jorge A.","family":"Gutierrez","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9744-5342","authenticated-orcid":false,"given":"Frederick G.","family":"Durrant","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0664-4571","authenticated-orcid":false,"given":"Shaun A.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3744-0451","authenticated-orcid":false,"given":"Nikita","family":"Chapurin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6480-0275","authenticated-orcid":false,"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4304-595X","authenticated-orcid":false,"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22741"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(00)80018-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815580978"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892419825695"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.10.020"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892420930953"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21090"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22120"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22819"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3082"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21292"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2016.30.4280"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2015.29.4186"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240401800611"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22487"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_18_1","unstructured":"OCEBM Levels of Evidence\u2014Centre for Evidence\u2010Based Medicine (CEBM) University of Oxford. 2020. 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