Racial differences in food allergy phenotype and health care utilization among US children


Published online: November 22, 2016

Food allergy (FA) is a prevalent condition in the USA, but little is known about its phenotypes in racial minority groups.

In a study published in The Journal of Allergy and Clinical Immunology: In Practice, Mahdavinia and colleagues conducted a large, retrospective cohort study of children ages 0 to 17 years with food allergy seen in Allergy/Immunology clinics at two urban tertiary care centers in the US. The objective of this study was to characterize disease phenotypes and disparities in healthcare utilization among African-American (AA), Hispanic, and White children with food allergy.

The cohort of 817 children was composed of 35% AA, 12% Hispanic, and 53% non-Hispanic Whites. Compared with non-Hispanic White children, AA children had significantly higher rates of having asthma and eczema, and significantly higher rates of allergy to wheat, soy, corn, fish and shellfish. Hispanic children had significantly higher rates of allergy to corn, fish and shellfish, and higher rates of having eczema, but similar rate of asthma. There was a significant difference in insurance type by race/ethnicity with 55%, 18%, and 11% of AA, Hispanic, and White children covered by Medicaid, respectively. Compared with Whites, AA and Hispanic children had shorter duration of follow up for FA with allergy specialist and higher rates of FA-related anaphylaxis and ER visits.

Food allergy phenotypes and health care utilization differ among children of different racial/ethnic backgrounds in the US that put AA and Hispanic children at higher risks of adverse outcome than White children, including co-existent atopic conditions, less well recognized food allergens and higher rates of anaphylaxis. These findings call for future investigation of these issues and the need for culturally-sensitive educational programs to improve FA outcomes for all children.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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