Published Online: August 28, 2014
Studies suggest individuals of low education and/or income, new Canadians, and Aboriginal people (vulnerable populations) may have fewer food allergies than the general population. However, given the difficulty in recruiting such populations using conventional survey methodologies, the prevalence of food allergy among these populations in Canada has not been estimated.
In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Soller et al. specifically targeted and evaluated prevalence of food allergy in vulnerable populations of children and adults in all Canadian provinces and territories, compared vulnerable with non-vulnerable populations, and examined potential socio-demographic determinants of food allergy.
Using 2006 Canadian Census data, postal codes with high proportions of vulnerable populations were identified and households randomly selected to participate in a telephone survey. Information on food allergies and demographics was collected. Prevalence estimates were weighted using Census data to account for the targeted sampling. Multivariable logistic regression was used to identify predictors of food allergy.
Of 12,762 eligible households contacted, 5,734 households completed the questionnaire (45% response rate). Self-reported food allergy was less common among adults without post-secondary education versus those with post-secondary education [6.4% (95% confidence interval [CI], 5.5% to 7.3%) versus 8.9% (7.7% to 10%)] and new Canadians versus those born in Canada [3.2% (2.2% to 4.3%) versus 8.2% (7.4% to 9.1%)]. There was no difference in prevalence between those of low and high income or those with and without Aboriginal identity.
This study suggests that Canadians with lower education and new Canadians have fewer food allergies. The difference may reflect true prevalence, an artifact resulting from study limitations, or the result of actual disparities in health care impacting diagnosis. It is possible that the lower prevalence in these vulnerable populations is partially due to under-diagnosis due to their inadequate access to health care services because of geographic, bureaucratic, cultural, and language barriers. These issues highlight important gaps in health care policy, and more research is needed to identify and address these impediments to ensure that all Canadians have an equal opportunity to seek and receive appropriate care.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.