Socioeconomic Disparities in the Economic Impact of Childhood Food Allergy

Abstract

We compared direct medical costs borne by the health care system and out-of-pocket costs borne by families for children with food allergy by socioeconomic characteristics. We analyzed cross-sectional survey data collected between November 2011 and January 2012 from 1643 US caregivers with a food-allergic child. We used a 2-part regression model to estimate mean costs and identified differences by levels of household income and race or ethnicity. Children in the lowest income stratum incurred 2.5 times the amount of emergency department and hospitalization costs as a result of their food allergy than higher-income children ($1021, SE ±$209, vs $416, SE ±$94; P < .05). Costs incurred for specialist visits were lower in the lowest income group ($228, SE ±$21) compared with the highest income group ($311, SE ±$18; P < .01) as was spending on out-of-pocket medication costs ($117, SE ± $26, lowest income; $366, SE ±$44, highest income; P < .001). African American caregivers incurred the lowest amount of direct medical costs and spent the least on out-of-pocket costs, with average adjusted costs of $493 (SE ±$109) and $395 (SE ±$452), respectively. Disparities exist in the economic impact of food allergy based on socioeconomic status. Affordable access to specialty care, medications, and allergen-free foods are critical to keep all food-allergic children safe, regardless of income and race.