Socioeconomic disparities in the economic impact of childhood food allergy

OBJECTIVES: We compared direct medical costs borne by the health care system and out-of-pocket costs borne by families for children with food allergy by socioeconomic characteristics. METHODS: We analyzed cross-sectional survey data collected between November 2011 and January 2012 from 1643 US caregivers with a food-allergic child. We used a 2-part regression model to estimate mean costs and identified differences by levels of household income and race or ethnicity. RESULTS: Children in the lowest income stratum incurred 2.5 times the amount of emergency department and hospitalization costs as a result of their food allergy than higher-income children (1021, SE ±209, vs 416, SE ±94; P < .05). Costs incurred for specialist visits were lower in the lowest income group (228, SE ±21) compared with the highest income group (311, SE ±18; P < .01) as was spending on out-of-pocket medication costs (117, SE ± 26, lowest income; 366, SE ±44, highest income; P < .001). African American caregivers incurred the lowest amount of direct medical costs and spent the least on out-of-pocket costs, with average adjusted costs of 493 (SE ±109) and 395 (SE ±452), respectively. CONCLUSIONS: Disparities exist in the economic impact of food allergy based on socioeconomic status. Affordable access to specialty care, medications, and allergen-free foods are critical to keep all food-allergic children safe, regardless of income and race.