Ruchi S. Gupta, MD, MPH

Credit: Feinberg School of Medicine

Asian, Black, and Hispanic populations in the United States may face a higher burden of food allergies compared to their White counterparts, according to new findings.¹

These findings were the result of a study done to expand the existing literature on the distribution of food allergies across ethnic, racial, and socioeconomic subpopulations besides Whites and Blacks, which have already been researched extensively.²

The research was authored by Ruchi S. Gupta, MD, MPH, from the Center for Food Allergy & Asthma Research at Northwestern University’s Feinberg School of Medicine.

“Therefore, this study aimed to estimate the distribution of self-reported or parent-reported, “convincing” FAs, reaction severity, and management among individuals of varying racial, ethnic, and socioeconomic backgrounds in the US,” Gupta and colleagues wrote.

Background and Findings

The investigators conducted a population-based survey from October 9, 2015, to September 18, 2016, involving 51,819 households within the United States. Their survey collected responses from 38,408 children—aged ≤18 years—as reported by their parents, and from 40,443 adults—aged >18 years—who self-reported their responses.

The research team’s survey was conducted through telephone or online methods, and the sampling techniques they used were probability-based and included a deliberate focus on rural and low-income households which are often underrepresented in surveys that rely on address-based or convenience sampling.

The research activities of this study were approved by the institutional review boards of Northwestern University and NORC (National Opinion Research Center) at the University of Chicago, and each of the participants gave written or oral informed consent.

The investigators sought to assess the prevalence of food allergies to common food allergens among different ethnic and racial groups, as well as to examine related elements such as allergic reaction symptoms, comorbid atopic conditions, emergency department visits, severe food allergies, and prescription of epinephrine.

The research team’s prevalence calculations took into account self-reported or parent-reported allergies, which included those corroborated by a history of IgE-mediated FA symptoms, as well as confirmed the allergies which were diagnosed by physicians through oral food challenges, specific IgE testing, or skin prick. Severe food allergies were identified by the team based on specific symptoms involving multiple organ systems.

The investigators assessed participant food allergies and the associated clinical outcomes were assessed and examined for prevalence using race—including Asian, White, Asian, and >1 race or another race), ethnicity being Hispanic and non-Hispanic, and income of a household.

The team’s survey ended up with 51,819 households and a total of 78,851 individuals, consisting of 40,443 adults and 38,408 children and a majority of women. The prevalence of self-reported or parent-reported allergies varied among the different groups, with the lowest rates reported for non-Hispanic White individuals at 9.5%.

The investigators noted that rates were 10.5% for Asians, 10.6% for Hispanics, and 10.6% for non-Hispanic Black individuals. They added that prevalence of common food allergens also was found to have differed by ethnicity and race, and non-Hispanic Black participants were more likely to report allergies to multiple foods.

Furthermore, non-Hispanic White and Asian individuals showed lower rates of severe food allergy reactions compared to other groups. The investigators also concluded that households with an annual income exceeding $150,000 reported the lowest prevalence of self-reported or parent-reported food allergies at a rate of 8.3%.

“This survey study suggests that, in the US, Asian, Black, and Hispanic populations appear to experience greater FA burden compared with their White counterparts,” they wrote. “Further efforts should be undertaken to evaluate the sociocultural and economic covariates associated with racial and ethnic differences in FA burden and to explore additional factors such as cultural heterogeneity within racial and ethnic groups experiencing FAs.”

References

1. ^{Jiang J, Warren CM, Brewer A, Soffer G, Gupta RS. Racial, Ethnic, and Socioeconomic Differences in Food Allergies in the US. JAMA Netw Open. 2023;6(6):e2318162. doi:10.1001/jamanetworkopen.2023.18162.}
2. ^{Keet CA, Savage JH, Seopaul S, Peng RD, Wood RA, Matsui EC. Temporal trends and racial/ethnic disparity in self-reported pediatric food allergy in the United States. Ann Allergy Asthma Immunol. 2014;112(3):222-229.e3. doi:10.1016/j.anai.2013.12.007.}