Study questions why far fewer low-income children have diagnosed food allergies

Allergy researchers have uncovered a large discrepancy in estimates of food allergy prevalence in children on US Medicaid compared to the general population.

Medicaid is a US federal and state program that helps with medical costs for low-income individuals and families. To estimate prevalence of food allergy diagnosis, the study collected a person-level dataset of 23,825,160 which included all children ages 0 to 19 years as of 1 January 2012 who were continuously enrolled in Medicaid in 2012. The prevalence of food allergy among children enrolled on Medicaid was only 0.6 per cent, compared to the national estimate of 7.6 per cent determined using parent surveys, and reports of physician confirmation of food allergy of 4.7 per cent.

In press coverage related to the publication of these findings, senior study author Ruchi Gupta suggests food allergy may be under-diagnosed among Medicaid-enrolled children, with families in the Medicaid program potentially encountering barriers to accessing and affording specialists and care.

The study also found strong associations between race/ethnicity and food allergy. Compared to Caucasian children, Asian children had 24 per cent higher odds of having food allergy, while Pacific Islander/Native Hawaiian children had 26 per cent higher odds and African-American children had seven per cent higher odds of food allergy. In contrast, Hispanic children had 15 per cent lower odds and Native American children had 24 per cent lower odds of having food allergy compared to Caucasian children.

Reference: Bilaver et al. Academic Pediatrics 2020. DOI: 10.1016/j.acap.2020.03.005

Additional reporting: See the media report issued by the Ann & Robert H. Lurie Children’s Hospital of Chicago.