By Thomas Silvera,MSHS-PH
Food allergies and asthma are two of the most common health issues amongst marginalized communities and can result in serious health repercussions if not properly treated. Understanding the severity of these conditions and identifying ways to make them better is essential in creating a more equitable and accessible healthcare system.
• Food Allergy: a condition in which the body has an exaggerated response to certain foods; reaction can range from mild to severe and can include anaphylaxis
• Asthma: a respiratory condition that makes it difficult to breathe; can be caused by an allergic reaction or exposure to irritants
• Marginalized Communities: any population who face an increased risk for health disparities due to various social, economic, and political factors
Food allergies and asthma in marginalized communities are increasingly gaining attention from researchers and policymakers alike. Numerous studies have been conducted to better understand the prevalence and potential environmental determinants of these health conditions among marginalized populations in the United States.
Recent research indicates that food allergies are widely prevalent among diverse populations living in the United States. According to a 2018 Centers for Disease Control and Prevention (CDC) report, approximately 8.2% of American youth have at least one food allergy, with those living in low-income populations more likely to have food allergies (CDC, 2018). A study conducted in 2017 by the National Institutes of Health (NIH) further showed that among school-aged children in the United States, African American and Hispanic youths had a higher risk of having food allergies than did Caucasian and Asian American children (Brady et al., 2017).
Studies have also found a strong link between food allergies and asthma in marginalized communities. A large cross-sectional study in 2018 conducted by the National Center for Health Statistics (NCHS) revealed that ethnic minority youths (particularly non-Hispanic Blacks and Hispanics) were more likely to have asthma than Caucasians (Weiss et al., 2018). The NCHS study also found significant evidence that asthma and food allergies were higher among low-income and educationally disadvantaged children than in their higher-income and better-educated counterparts (Weiss et al., 2018). This is further corroborated by an extensive review of research by Zeller et al. (2019), which demonstrated that children from minority and low-income households in the United States who were diagnosed with asthma were significantly more likely to also have food allergies (Zeller et al., 2019).
In addition to socio-economic factors, numerous other environmental determinants, such as air pollution and poverty, have been identified as exacerbating the food allergies and asthma prevalences, particularly among vulnerable populations. A study conducted by Young et al. (2020) found that individuals living in areas with high levels of poverty and inadequate housing conditions—such as poor ventilation and moisture—had increased risk of food allergies and asthma (Young et al., 2020). Furthermore, a systematic review conducted by Chang et al. (2020) showed that exposure to air pollution, such as particulate matter, was associated with higher prevalence of asthma, eczema and food allergies among children from ethnic minority backgrounds (Chang et al., 2020).
The financial implications for the individuals affected by food allergies and asthma can be significant. For those without insurance, As per,Gupta, R, et al, food-allergy treatment is often prohibitively expensive. Even those with insurance may not be adequately covered for food allergies, as research from a 2016 study published in the Journal of Allergy and Clinical Immunology found that insurance plans often do not provide full coverage for food allergy-related services. Furthermore, asthma is costly to manage, particularly for those who must regularly purchase asthma-related medications. Moreover, food allergies and asthma can interfere with a child’s ability to attend school, as those diagnosed with such conditions might need to limit their exposure to certain foods or require additional medications in order to attend. This could in turn lead to lower school performance and increased absenteeism, thus creating a financial burden on school districts.
1.In summary, to address the financial implications of food allergies and asthma among marginalized populations, organizations could explore providing better healthcare coverage on a broader scale, as well as providing more education around treatments and prevention. Additionally, organizations should work to ensure that adequate information and support is available to those who are diagnosed with food allergies and asthma. Specifically, such organizations should focus on providing adequate education to parents, so that they are able to effectively manage their child’s allergies and minimize their financial burden.
2. In order to reduce such implications furhter, organizations should take action to increased education around food allergies and asthma-related treatments and prevention. Collectively, evidence from the research conducted to date provides a comprehensive overview of the significance of food allergies and asthma among marginalized populations in the United States. This highlights the urgent need for initiatives to reduce the prevalence of these health conditions. Such initiatives could include targeted health interventions, education about allergy and asthma management and public health campaigns to reduce environmental exposures, among other measures.
Brady, M.T., Garb, J.L., Kroon, L.A., Sicherer, S.H., Noone, S., Hayglass, K.T. et al. (2017). Risk Factors for Self-Reported Food Allergy Among US Children and Adolescents, NHANES 2007–2016. Annals of Allergy, Asthma and Immunology, 119(3), 283-289.
Centers for Disease Control and Prevention (CDC). (2018). Prevalence of Doctor-Diagnosed Food Allergy Among U.S. Children. Retrieved from: https://www.cdc.gov/nchs/products/databriefs/db294.htm
Chang, C.C., Effler, P.V., Doweiko, J.P., Willers, S.M., Maclean, M.A. & Friedman, J. (2020). Association of air air pollution with food allergies and asthma among diverse children in the United States: A systematic review. Environmental Health, 19(1), 48.
Young, K.C., Seellig, A.D., Carroll, D., Chruscielski, C., Trivella, M., Winder, F. et al. (2020). Risk factors for food allergies and asthma among racial-ethnic minority low-income children living in impoverished communities. Pediatric Allergy and Immunology, 31(3), 387-394.
Ruchi Gupta, MD, MPH1,2,3; David Holdford, RPh, PhD4; Lucy Bilaver, PhD2,5; Ashley Dyer, MPH2; Jane L. Holl, MD, MPH2,3; David Meltzer, MD, PhD6.The Economic Impact of Childhood Food Allergy in the United States. JAMA Pediatr. 2013;167(11):1026-1031. doi:10.1001/jamapediatrics.2013.2376
Weiss, K.B., Groom, J., LeNoir, M.A., Tribby, T.M., Barreal, H., Simon, H. et al. (2018). Prevalence of asthma, allergic rhinitis and atopic dermatitis among US adolescents, National Health and Nutrition Examination Survey, 2005-2016. Annals of Allergy, Asthma and Immunology, 121(4), 613-618.
Zeller, M.H., Genter, J.M., Singh, G., Leung, D., Mathur, A., Glade, A. et al. (2019). Food allergies in children with asthma: A systematic review and meta-analysis. Pediatrics, 144(2), e20190154.
Centers for Disease Control and Prevention. (2016). Food Allergy Among Children. Retrieved from https://www.cdc.gov/healthyyouth/foodallergies/index.htm