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Does race determine access to allergen-free foods for children?

Published: August 18, 2021

Previous studies have shown that Black children with food allergies (FA) have worse clinical outcomes than White children with FA. What is not known is whether differences in access to allergen-free foods are a contributing factor to some of the racial differences. The goal of this study was to examine access to allergen-free food and living in a food desert among Black and White children with FA living in urban areas in the Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD) cohort.

The study by Coleman et al. in The Journal of Allergy and Clinical Immunology: In Practice used data from the FORWARD cohort of Black and White children <= 12 years old with physician-diagnosed FA from Chicago (Ann & Robert H. Lurie Children’s Hospital, Rush University Medical Center), Cincinnati (Cincinnati Children’s Hospital), and Washington, DC (Children’s National Hospital). Researchers surveyed participants to learn whether they had access to allergen-free food in person and online. Researchers also gathered demographic data about the participants’ identified race, gender, age, caregiver education, and annual household income. Geospatial mapping data were used to determine if participants lived in a food desert.

The study consisted of 70.2% White and 29.8% Black participants. With regard to access, only 5.4% of participants lived in a food desert as defined by the United States Department of Agriculture. Despite this finding, there was a significant association between living in a food desert and race, with 13% of Black children living in a food desert compared to 2.1% of White children. There was also a significant association of living in a low-income census tract and race, with more Black children (68%) living in a low-income census tract. When adjusting for gender, age, FA, income, parental education, FA knowledge, and recruitment site, White children were 2.4 times as likely to have access to allergen-free foods compared to Black children, but this was not statistically significant. Researchers found both race and socioeconomic status to be significant predictors of access to allergen-free foods. These findings should help guide clinical practice and management of food avoidance by providing equitable resources for patients to access allergen-free foods.

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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