Six million children in the U.S. have a food allergy.
That’s one in 13 kids, but that ratio varies depending on what neighborhood you are in.
Children from low-income areas are more likely to have food allergies.
They’re also less likely to be diagnosed by a specialist or to receive epinephrine shots for severe reactions.
As a result, lower-income families spend 2.5 times more on emergency room visits and hospitalization costs due to allergic reactions than higher-income families.
Lack of education and medical access also means that children from low-income families are more likely to have life-threatening allergic reactions.
These are among the findings of a new study published today in the May issue of Pediatrics, the journal of the American Academy of Pediatrics.
In the study, researchers examined the degree of disparity in direct medical and out-of-pocket costs associated with food allergies across socioeconomic groups.
The lowest income families paid $1,021 per year for emergency and hospitalization costs compared with $416 per year for the highest income group.
Dr. Ruchi Gupta, M.P.H., was lead investigator for a research team that analyzed the data from their national survey of 1,643 caregivers of children with food allergies.
Gupta is an associate professor of pediatrics at Northwestern University Feinberg School of Medicine and an attending physician at Ann & Robert H. Lurie Children’s Hospital of Chicago.
She has conducted food allergy research for 12 years and is author of the 2012 book “The Food Allergy Experience.”
“This data suggests that low-income families may not have access to specialists, or to safe foods and medications, which puts them at higher risk for allergic reactions leading to emergency room visits,” Gupta told Healthline. “Improved policies, including access to medications like epinephrine auto-injectors and affordable allergen-free foods in grocery stores, are critical to keep all children with food allergy safe.”
Debra Indorato, a registered dietitian and licensed dietitian-nutritionist, has served since 2005 as nutrition advisor on the medical advisory team of Kids with Food Allergies, a division of the Asthma and Allergy Foundation of America (AAFA).
“The most common food allergies in infants and children are eggs, milk, peanuts, tree nuts, soy, and wheat,” she told Healthline. “Children may outgrow some allergies such as egg, milk, and soy but may be less likely to outgrow others.”
Lack of Treatment
Children from low-income families, because they are less likely to be seen by a physician, also experienced the lowest direct medical and out-of-pocket expenses for treating allergic reactions to food.
Gupta and her colleagues said this suggests that these children have less access to specialty care, allergen-free foods, and medications.
These children also may be at higher risk for accidentally ingesting allergy-triggering foods and, consequently, for anaphylaxis, a severe life-threatening allergic reaction.
“The cost of epinephrine auto-injectors presents an economic burden to low-income families,” Gupta wrote in the report. “The families often lack the financial means and access to allergen-free foods to prevent allergic reactions in the first place.”
In addition, the AAFA says that families are often unaware that some manufacturers offer low-cost or free epinephrine.
The Cost to Society
The national cost of food allergies is enormous.
Gupta and her colleagues noted in the study that food allergy prevention and treatment costs almost $25 billion each year, or $4,184 per child.
That includes direct medical costs borne by healthcare systems as well as medical and nonmedical costs borne by families.
In addition, the AAFA reports that people of all ages visit the emergency room about 200,000 times each year because of food allergies. Almost 10,000 people with food allergies end up in the hospital each year.
Of children with food allergies, almost 39 percent have a history of severe reactions, according to the American College of Allergy, Asthma, & Immunology.
The impact of childhood food allergies is extensive and growing.
“A number of working theories suggest reasons for the increase,” Indorato said. “The most prominent is the ‘Hygiene Theory.’ Interestingly, lesser-developed nations tend to show lower incidence of food allergies within their populations. This suggests that if children are exposed to a wide variety of bacteria and microbes through their environment, it may lead to lower incidence of food allergies. But, some reports suggest that fewer medical resources mean individuals go undiagnosed.”
Are new food allergies developing?
“Not so much new allergies,” Indorato said, “but anyone can develop food allergies throughout life as their immune system changes, or is put under pressure by other diseases. Another factor is new ingredients in foods created by manufacturers, which can trigger allergies. Often, consumers will not know a new ingredient has been added until they begin to experience a reaction.”
Government can work with medical professionals to address the prevalence and danger of food allergies.
“Local and state governments can help with policies to keep all kids safe,” Gupta said. “We need to make sure all kids have access to epinephrine auto-injectors in schools and public places. We also need to assure kids have access to safe foods at affordable costs. There should be an allergen-free food aisle in all grocery stores. We also need to improve our labeling laws.”