"We were surprised to find such a large discrepancy in estimates of food allergy prevalence in children on Medicaid compared to the general population," said senior study author Dr. Ruchi Gupta, a pediatrician and food allergy researcher at Children's Hospital of Chicago.
"Our findings suggest potential under-diagnosis of food allergy among Medicaid-enrolled children," Gupta said in a hospital news release. "Families in the Medicaid program may be encountering barriers to accessing and affording specialists and potentially lifesaving epinephrine prescriptions."
Food allergies affect millions of U.S. children and cause significant emotional and financial burdens on affected families.
Gupta's team analyzed Medicaid claims data for over 23 million children on Medicaid, the publicly insured insurance plan for the poor. They found the rate of food allergies was 0.6%. That's far below previous U.S. parent survey-based estimates of nearly 8% and physician confirmation of food allergies at about 5%.
The researchers also found strong associations between race/ethnicity and food allergies.
Compared to white children, Pacific Islander/Native Hawaiian children and Asians were about 25% more likely to have food allergies. Black children were 7% more likely to have food allergies, while Hispanic kids were 15% less likely and American Indian/Alaskan Native children were 24% less likely.
The results also "show that some of the racial differences in food allergy prevalence found in the general population persist among children enrolled in Medicaid," Gupta said.
Future research needs to determine whether racial and ethnic differences in prevalence are associated with disparities in adequate food allergy management, Gupta said. Such management includes patient education on allergen avoidance and up-to-date epinephrine prescriptions.
Previous research by Gupta found that 40% of children with food allergies have a life-threatening reaction in their lifetime, and 1 in 5 have at least one food allergy-related emergency department visit a year.
The study was recently published in the journal Academic Pediatrics.