Advancing Food Allergy Through Epidemiology: Understanding and Addressing Disparities in Food Allergy Management and Outcomes

Abstract

Epidemiological studies have been pivotal in advancing understanding of the etiology of food allergy and in guiding the development of evidence-based guidelines for food allergy prevention and clinical management. In recent years, as research into the population-level distribution and determinants of food allergy has accumulated, data indicate that substantial differences in food allergy outcomes and management exist across racial/ethnic and other socioeconomic strata. This clinical commentary aims to provide a review of existing epidemiological studies and shed valuable light on the disparate burden of food allergy. Emerging methods to quantify environmental exposure and food allergy outcomes are detailed, as are specific areas in which future research is warranted. We also highlight the role that epidemiology plays in advancing health equity and provide a framework as to how it can effectively inform health policy at all phases of the policy cycle-from initial population health assessment to the evaluation and refinement of specific health policies (ie, national guidelines to promote earlier introduction of peanut-containing foods for allergy prevention).

Keywords: Ecological momentary assessment; Epidemiology; Food allergy; Food allergy management; Health disparities; Health equity; Population health; Social determinants of health.

Figure 1.

Estimated Prevalence of Current Food Allergy Among the US General Population by Race/Ethnicity reported by Gupta et al (2018, 2019)^,

Figure 2.

Estimated Racial/Ethnic Differences in Food Allergy Phenotypes and Health Care Utilization

Figure 3.

Role of epidemiology in informing policy related to earlier introduction of food allergens to prevent food allergy