A review of multiple studies of the prevalence of food allergies by race, geography and socioeconomic status recently found that vulnerable children may have a greater prevalence of allergies. They also may be at greater risk and experience disparities in management. The number of studies on this topic is limited, but initial evidence is convincing. Researchers hope that work done to reduce disparities in vulnerable children with asthma could do the same for those with food allergies
Racial and Geographic Disparities in Food Allergies
The study from 2013 was a review of studies that investigated the prevalence of food allergies in children in certain vulnerable populations. Several studies indicated that African American children have a higher prevalence of food allergies as compared to white children in the U.S. Studies have also shown that children born in the U.S. to immigrant parents had a high risk of developing allergies, as compared to children born outside the U.S.
In terms of geography, children living in urban environments were more likely to have food allergies as compared to suburban and rural children. These results were still seen after controlling for income and race and were based on actual allergy tests. But, when the studies relied on parental report, the prevalence of food allergies was low. This may indicate that parents in urban areas are not aware of food allergies, their symptoms or testing for them.
Disparity in Management of Food Allergies
Another important racial disparity found in the research was that African American and Asian children were more likely to report, or their parents were more likely to report, food allergies. However, these same children were less likely to be given a formal diagnosis. This is important because without a diagnosis, the real issue may remain unknown and the child will not get treatment or appropriate management strategies.
The distribution and use of epinephrine auto-injectors, life-saving devices for anaphylaxis, also show racial disparities. Studies show that white children with a documented reaction to a food were more likely to have an auto-injector before visiting an emergency room for anaphylaxis, as compared to non-white children. White children were also at a lower risk for needing hospitalization. Other studies showed that African American children with food allergies were more likely to be unable to afford an injector and to have low food security.
Applying the Lessons from Asthma Disparities
Similar disparities are seen with asthma, but asthma has been studied more extensively and for a longer period of time. Those studies that uncovered the disparities led to interventions that proved to be effective. These included educating health care providers as well as families and children, intensive coordination of care, and mobile health interventions in at-risk communities.
The disparities are still being uncovered, and there are some issues with the limited research that has so far been conducted on food allergies in vulnerable populations. Still, the disparities seem to exist and this means that certain children are suffering more than is necessary and are at risk for anaphylaxis without adequate management. More research and intervention methods, like those used for children with asthma, will hopefully help change and shrink these disparities.