The prevalence and characteristics of food allergy in urban minority children

Abstract

BackgroundUrban minority children are known to have high rates of asthma and allergic rhinitis, but little is known about food allergy in this population. ObjectiveTo examine the prevalence and characteristics of food allergy in an urban pediatric population. MethodsA retrospective review of electronic medical records from children seen in the hospital-based general pediatric clinic at Mount Sinai Hospital serving East Harlem, NY, between July 1, 2008 and July 1, 2010 was performed. Charts for review were selected based on diagnosis codes for food allergy, anaphylaxis, or epinephrine autoinjector prescriptions. ResultsOf 9,184 children seen in this low-income, minority clinic, 3.4% (313) had a physician-documented food allergy. The most common food allergies were peanut (1.6%), shellfish (1.1%), and tree nuts (0.8%). Significantly more black children (4.7%) were affected than children of other races (2.7%, P < .0001), which consisted primarily of Hispanic and multiracial children. Anaphylaxis was most frequently documented for peanut (15.1%), fish (12.5%), and milk (11.1%). Among food-allergic children, asthma (50%), atopic dermatitis (52%), and allergic rhinitis (49%) were common. Fewer than half had confirmatory testing or evaluation by an allergy specialist, and although most had epinephrine autoinjectors prescribed, most were not prescribed food allergy action plans. ConclusionThis is the largest study of food allergy prevalence in an urban minority pediatric population, and 3.4% had physician-documented food allergy. Significantly more blacks were affected than children of other races. Fewer than half of food-allergic children in this population had confirmatory testing or evaluation by an allergy specialist.