Food Allergy Rates Highest in Asian, Black, and Hispanic Individuals

Food allergies (FA) are more commonly reported by individuals who are Asian, Black, and Hispanic vs those who are White, according to study findings published in JAMA Network Open.

Investigators sought to determine the distribution of food allergies among US individuals by race/ethnicity and socioeconomic level.

The investigators conducted a population-based survey from October 9, 2015, to September 18, 2016, of 51,819 US households, collecting parent-reported responses for 38,408 children (aged ≤18 years) and self-reported responses from 40,443 adults (aged >18 years). Adults completed the survey via telephone or online in English or Spanish.

The primary outcomes were overall pediatric and adult self-reported prevalence of any FA(s) to cow’s milk, hen’s egg, peanut, tree nuts, soy, wheat, sesame, fin fish, and shellfish in various racial and ethnic groups. Statistical analysis was performed from September 1, 2022, through April 10, 2023.

The surveys were completed for 78,851 individuals (40,443 adults and 38,408 children; 51.1% women [95% CI, 50.5%-51.6%]; mean [SD] age of adults, 46.8 [24.0] years; mean [SD] age of children, 8.7 [5.2] years). The responders were 3.7% Asian, 12.0% Black, 17.4% Hispanic, 62.2% White, and 4.7% individuals who self-identified as having more than 1 race or “other” race.

Across all age groups, an estimated 5.0% of US individuals had a physician-confirmed FA, and 10.1% had a convincing FA (defined by investigators as “self-reported or parent-reported FAs corroborated by a history of symptoms related to an IgE-mediated FA”). In a comparison of convincing FAs by race and ethnicity, 10.5% (95% CI, 9.1%-12.0%) of Asian individuals, 10.6% (95% CI, 9.8%-11.5%) of Black individuals, 10.6% (95% CI, 9.7%-11.5%) of Hispanic individuals, and 9.5% of (95% CI, 9.2%-9.9%) White individuals had a convincing FA.

The highest rate of convincing FAs was observed in Black children (8.9%; 95% CI, 7.6%-10.3%), and Asian children had the lowest rate (6.5%; 95% CI, 5.1%-8.2%). Black children also had the highest rate of convincing peanut allergy (3.0%; 95% CI, 2.4%-3.8%).

Among adults, White adults had the lowest rate of convincing FAs among all adults (10.1%; 95% CI, 9.7%-10.6%) vs other races and ethnicities. Asian adults had the highest prevalence of peanut allergy (2.9%; 95% CI, 2.0%-4.2%) and shellfish allergy (3.8%; 95% CI, 3.0%-4.9%).

Convincing FAs occurred most frequently in households that earned $50,000 to $99,999 per year (10.7%; 95% CI, 10.2%-11.3%), and the lowest rates were in those earning $150,000 or more per year (8.3%; 95% CI, 7.4%-9.2%).

Black individuals had the highest rate of multiple convincing FAs (50.6%; 95% CI, 46.1%-55.1%) vs other races and ethnicities. Asian and White individuals had the lowest rates of severe food allergy reactions (Asian: 46.9%; 95% CI, 39.8%-54.1%; and White: 47.8%; 95% CI, 45.9%-49.7%).

According to a model of logistic regressions adjusted for sex, age, geographic region, household income, and atopic comorbidities, a greater likelihood of having 1 or more convincing FA was found in Asian individuals (adjusted odds ratio [AOR], 1.21; 95% CI, 1.02-1.43; P =.03), Black individuals (AOR, 1.15; 95% CI, 1.03-1.29; P =.02), Hispanic individuals (AOR, 1.17; 95% CI, 1.04-1.30; P =.006), and those claiming more than 1 race or other race (AOR, 1.46; 95% CI, 1.23-1.71; P <.001), compared with White individuals.

Among several limitations, racial and ethnic subpopulations were not analyzed, and the results were limited by the reliance on self-reported or parent-reported data. In addition, the survey was conducted in English and Spanish language only.

“This study suggests that racial, ethnic, and socioeconomic differences in the prevalence of food allergies exist and are evident in clinical outcomes such as food allergy-related emergency department visits and epinephrine autoinjector use,” stated the researchers.

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.