Access to Allergen-Free Food Among Black and White Children with Food Allergy in the FORWARD Study

Amaziah T. Coleman*, Hemant Sharma, Adam Robinson, Andrea A. Pappalardo, Eileen Vincent, Jamie L. Fierstein, Mech Frazier, Lucy Bilaver, Jialing Jiang, Johnathan J. Choi, Ashwin Kulkarni, Susan Fox, Christopher Warren, Mahboobeh Mahdavinia, Mary Tobin, Amal Assa'ad, Ruchi Gupta

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Racial differences in access to allergen-free food have not been fully described among children with food allergy (FA). Objective: To examine access to allergen-free foods among Black and White children with FA. Methods: Black and White children with FA were enrolled in Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD), a multisite prospective cohort study at 4 urban US centers. Caregivers completed questionnaires regarding access to allergen-free foods. Univariable statistics described demographics. Bivariable statistics evaluated crude associations with access to allergen-free foods. Multivariable logistic regression evaluated the adjusted effect of race on access to allergen-free foods. Geospatial analyses examined the distribution of race, socioeconomic status, and food desert residence. Results: Among participants (n = 336), White caregivers (88.1%) were more likely to report access to allergen-free foods than Black caregivers (59%) (P <.001). White caregivers were more likely to purchase allergen-free foods online (35.2%) than Black caregivers (12%) (P <.001). Although Black children were more likely to live in a food desert, access to allergen-free food was not related to food desert residence. In the unadjusted analysis, White children were 5.2 times as likely to have access than Black children (P <.001); after adjusting for demographics, this increase in access was no longer significant (P =.08). Other predictors of access to allergen-free foods included online food purchasing, annual household income, respondent education level, milk allergy, and child age >5 years. Conclusion: In the FORWARD cohort, Black children have less access to allergen-free foods than White children, but much of the difference is accounted for by socioeconomic status and other participant characteristics.

Original languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number1
StatePublished - Jan 2022


  • Access
  • Black
  • Children
  • Disparities
  • Food allergy
  • Race
  • White

ASJC Scopus subject areas

  • Immunology and Allergy


Dive into the research topics of 'Access to Allergen-Free Food Among Black and White Children with Food Allergy in the FORWARD Study'. Together they form a unique fingerprint.

Cite this