The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States

Abstract

<p class="first" id="d547107e233">A 2015–2016 population-based, cross-sectional survey was administered to a sample of US households to estimate current FA prevalence, severity, and health care use. </p><div class="section"> <a class="named-anchor" id="vid01"> <!-- named anchor --> </a> <p id="d547107e238"> <div class="fig panel" id="vid1"> <a class="named-anchor" id="vid1"> <!-- named anchor --> </a> <div class="panel-content"> <div class="caption" id="d547107e241"> <p class="first" id="d547107e242"> <b>Video Abstract</b> </p> </div> <div class="figure-container"/> </div> </div> </p> </div><div class="section"> <a class="named-anchor" id="s01"> <!-- named anchor --> </a> <h5 class="section-title" id="d547107e256">BACKGROUND:</h5> <p id="d547107e258">Childhood food allergy (FA) is a life-threatening chronic condition that substantially impairs quality of life. This large, population-based survey estimates childhood FA prevalence and severity of all major allergenic foods. Detailed allergen-specific information was also collected regarding FA management and health care use. </p> </div><div class="section"> <a class="named-anchor" id="s02"> <!-- named anchor --> </a> <h5 class="section-title" id="d547107e261">METHODS:</h5> <p id="d547107e263">A survey was administered to US households between 2015 and 2016, obtaining parent-proxy responses for 38 408 children. Prevalence estimates were based on responses from NORC at the University of Chicago’s nationally representative, probability-based AmeriSpeak Panel (51% completion rate), which were augmented by nonprobability-based responses via calibration weighting to increase precision. Prevalence was estimated via weighted proportions. Multiple logistic regression models were used to evaluate FA predictors. </p> </div><div class="section"> <a class="named-anchor" id="s03"> <!-- named anchor --> </a> <h5 class="section-title" id="d547107e266">RESULTS:</h5> <p id="d547107e268">Overall, estimated current FA prevalence was 7.6% (95% confidence interval: 7.1%–8.1%) after excluding 4% of children whose parent-reported FA reaction history was inconsistent with immunoglobulin E–mediated FA. The most prevalent allergens were peanut (2.2%), milk (1.9%), shellfish (1.3%), and tree nut (1.2%). Among food-allergic children, 42.3% reported ≥1 severe FA and 39.9% reported multiple FA. Furthermore, 19.0% reported ≥1 FA-related emergency department visit in the previous year and 42.0% reported ≥1 lifetime FA-related emergency department visit, whereas 40.7% had a current epinephrine autoinjector prescription. Prevalence rates were higher among African American children and children with atopic comorbidities. </p> </div><div class="section"> <a class="named-anchor" id="s04"> <!-- named anchor --> </a> <h5 class="section-title" id="d547107e271">CONCLUSIONS:</h5> <p id="d547107e273">FA is a major public health concern, affecting ∼8% of US children. However, &gt;11% of children were perceived as food-allergic, suggesting that the perceived disease burden may be greater than previously acknowledged. </p> </div>