Abstract
Objective: This review characterizes what is currently known about how prevalence, severity, distribution, and management of food allergy (FA) differ across socioeconomic strata and provides guidance for practicing clinicians about how to improve equity in research participation, health care delivery, and patient outcomes through a deeper understanding of the socioeconomic determinants of FA. Data Sources: Epidemiologic and biomedical literature published before April 2022. Results: Socioeconomic status (SES) is a complex concept that encompasses not only economic resources (eg, income, wealth) but also a person's social, economic, and political power and standing, each of which can affect health. However, in many studies of individuals and families with FA, assessment of SES has been limited and often a respondent's membership within a racial and ethnic group is used as a proxy for low SES. As a whole, findings from US population-based studies indicate a consistent trend: those who self-identify as non-Hispanic Black, and to a lesser extent other subpopulations who identify as being of non-White race and ethnicity, experience a greater burden of food-allergic sensitization and disease including higher rates of emergency health care utilization and food-induced anaphylactic fatality as compared with those identifying as non-Hispanic White. Conclusion: Reports of FA management and outcomes highlight inequities among specific low SES populations in the United States. Clinicians can and should act to reduce inequities by engaging more diverse populations in clinical research, equitably implementing FA risk screening and prevention, thoughtfully using emerging technologies to ameliorate disparities based on SES in health care delivery and outcomes, and advocating for social change.
Original language | English (US) |
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Pages (from-to) | 407-416 |
Number of pages | 10 |
Journal | Annals of Allergy, Asthma and Immunology |
Volume | 129 |
Issue number | 4 |
DOIs | |
State | Published - Oct 2022 |
Funding
Disclosures: Dr Warren reports receiving research support from the National Institutes of Health (NIH), Food Allergy Research & Education (FARE), and the Sunshine Charitable Foundation; being currently employed by Northwestern University; and being an Assistant Professor of Preventive Medicine at Northwestern University Feinberg School of Medicine. Dr Nimmagadda reports having previous speaking engagements for AstraZeneca and GlaxoSmithKline. Dr Bilaver reports receiving research support from the NIH (R21 ID # 1AI159562 AI135705, R01 ID # AI130348, U01 ID # AI138907), FARE, Thermo Fisher Scientific, and Genentech; being currently employed by Northwestern University; and being an Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. Dr Gupta reports receiving research support from the NIH (R21 ID # AI135705, R01 ID # AI130348, U01 ID # AI138907), FARE, Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific, and Genentech; and serving as a medical consultant and advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and FARE. Dr Gupta reports having ownership interest in Yobee Care, Inc; being currently employed by Ann & Robert H. Lurie Children's Hospital of Chicago; and being a Professor of Pediatrics & Medicine at Northwestern University Feinberg School of Medicine.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Immunology and Allergy
- Immunology