Abstract
Objective: The objective of this study is to provide a comprehensive epidemiological profile detailing food allergy (FA) prevalence and related correlates among Medicaid-enrolled children. Methods: The 2012 Medicaid Analytic eXtract person-level 100% files for 50 states and the District of Columbia were analyzed. The analytic sample of 23,825,160 included all children ages 0 to 19 years as of January 1, 2012 who were continuously enrolled in Medicaid in 2012. The prevalence of FA was measured using International Classification of Diseases, Ninth Revision, Clinical Modification codes and compared with other atopic conditions (atopic dermatitis, allergic rhinitis, and asthma). Logistic regression was used to evaluate child characteristics associated with FA. Results: The prevalence of FA among Medicaid-enrolled children was less than 1% (0.6%). State-level prevalence ranged from a high of 1.4% in Alaska to a low of 0.2% in Nevada. Race and ethnicity were associated with FA such that Asian, Black, and Pacific Islander/Native Hawaiian children had a higher odds of FA, while Hispanic and Native American children had 15% and 24% lower odds of FA, respectively, compared with White children. Conclusions: Compared with estimates of parent-reported, physician-diagnosed FA in the general population, the claims-based prevalence of FA among Medicaid-enrolled children is substantially lower. Racial and ethnic differences are consistent with the general population. The findings signal a need to better understand reasons for these differences including awareness, access to care, and service utilization patterns in this population.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 84-92 |
| Number of pages | 9 |
| Journal | Academic Pediatrics |
| Volume | 21 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2021 |
Funding
The authors would like to thank Jolanta Szkodon, BS—Ann & Robert H. Lurie Children's Hospital of Chicago; Alexandria Bozen, BS—Northwestern University Feinberg School of Medicine; Olivia Negris, MA—Northwestern University Feinberg School of Medicine; and Simran Kohli—University of Southern California; for their contributions to this project through data cleaning and editing assistance. Financial statement: This research study was supported by Thermo Fisher Scientific. The sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript. They did approve the decision to submit the manuscript for publication. Authorship statement: Dr Gupta conceptualized and designed the study and oversaw data acquisition, analysis, and interpretation; Dr Gupta had full access to the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis. Dr Bilaver conceptualized and designed the study, oversaw data acquisition, was responsible for data analysis and interpretation, and drafted the manuscript; Dr Bilaver had full access to the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr Fierstein participated in the study design and contributed to data analysis and interpretation. Ms Kanaley participated in the study design and contributed to data interpretation and drafting of the manuscript;, All authors reviewed and/or revised the manuscript and approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Conflict of Interest: Dr Gupta has received research grant support from The National Institutes of Health (NIH), Stanford Sean N. Parker Center for Allergy Research, Food Allergy Research & Education (FARE), UnitedHealth Group, Thermo Fisher Scientific, Genentech, and the National Confectioners Association (NCA); and has served as a medical consultant/advisor for Aimmune Therapeutics, Before Brands, Kaléo, Genentech, Food Allergy Research and Education, Allergenis, DOTS Technology, and DBV Technologies. Dr Bilaver has received research grant support from The National Institutes of Health (NIH), Rho Inc, HRSA, Thermo Fisher Scientific, Food Allergy Research and Education (FARE) Genentech, National Confectioners Association, Before Brands Inc. Conflict of Interest: Dr Gupta has received research grant support from The National Institutes of Health (NIH), Stanford Sean N. Parker Center for Allergy Research, Food Allergy Research & Education (FARE), UnitedHealth Group, Thermo Fisher Scientific, Genentech, and the National Confectioners Association (NCA); and has served as a medical consultant/advisor for Aimmune Therapeutics, Before Brands, Kaléo, Genentech, Food Allergy Research and Education, Allergenis, DOTS Technology, and DBV Technologies. Dr Bilaver has received research grant support from The National Institutes of Health (NIH), Rho Inc, HRSA, Thermo Fisher Scientific, Food Allergy Research and Education (FARE) Genentech, National Confectioners Association, Before Brands Inc.
Keywords
- Medicaid
- atopic
- children
- disparities
- food allergy
- prevalence
- socioeconomic
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health