RATIONALE: Increasing rates of food allergy are linked to higher socioeconomic status, but the relationship between socioeconomic status and hospitalization for food-induced anaphylaxis (FIA) is not clear. We sought to identify socioeconomic factors related to hospitalization for FIA.
METHODS: We utilized the Healthcare Cost and Utilization Project database from 2005 through 2012 to identify hospitalizations due to FIA. Cases were stratified by race (Caucasian, African American(AA), Hispanic, Asian/Pacific American(A/P), Native American(NA), Other), median household income national quartile for patient zip code, and primary payer (Medicaid, Medicare, Private, Self-pay, Other). Data were analyzed via Pearson’s chi-squared statistical analysis.
RESULTS: We identified 12597 hospitalizations due to FIA. Overall, 51% of FIA cases were identified as Caucasian, 22% AA, 14% Hispanic, 6% A/P, and 1% NA. Twenty five percent of FIA cases occurred within the lowest income quartile. Of these, 28% identified as Caucasian, 40% AA, 20% Hisp, 3.6% A/P and 2% NA. Cases in the lowest income quartile accounted for 14% of all FIA among Caucasians, 49% among AA, 40% among Hispanics, and 50% among NA. In this quartile, 43% of AA and 51% of Hispanics reported Medicaid as primary payer, compared with 16% of Caucasians. P<0.001 for all comparisons.
CONCLUSIONS: Hospitalizations for FIA occurs disproportionately in AA, Hispanic, and NA patients in the lowest income quartile and with Medicaid coverage, suggesting socioeconomic factors contribute to this risk. Targeted preventive measures such as improved subspecialty care, avoidance support, and active education/counseling about FIA may benefit these populations.