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Study: Low-income children with food allergies spend more for hospitals, less for medication :

April 27, 2016

Annual hospital bills for low-income children with food allergies are more than double those of higher-income peers, according to a new study.

“These results suggest that children in lower income families may be at a higher risk for accidental ingestions and anaphylaxis due to less access to specialty care, allergen-free foods and emergency medications like epinephrine auto-injectors,” authors said in the study “Socioeconomic Disparities in the Economic Impact of Childhood Food Allergy” (Bilaver LA, et al. Pediatrics. April 27, 2016,

Roughly 5.9 million children in the U.S. have a food allergy.Roughly 5.9 million children in the U.S. have a food allergy.


Roughly 5.9 million children in the U.S. have a food allergy, and nearly 40% of those have had a life-threatening reaction, according to the study. Preventing and treating allergic reactions costs about $4,184 annually per child.

Researchers analyzed survey data from 1,643 parents and caregivers of children with food allergies and categorized their annual household income into three levels: under $50,000, $50,000 to $100,000 and over $100,000.

They found families in the lowest income group incurred about $1,021 in adjusted annual emergency department and hospitalization costs compared to $434 a year for the middle income group and $416 for the highest income group. Meanwhile, the low-income group spent less on specialists and medications.

In a breakdown by race, researchers found African-American families spent the least on both direct medical and out-of-pocket costs compared to other groups.

“This finding may represent a protective effect within the environments of African American children that is not well understood,” the authors said.

They acknowledged limitations to the study, including the lack of information about the types of health insurance families used, potential errors in the costs caregivers reported and the inclusion of some families from advocacy groups.

Still, they said the results show work needs to be done to improve children’s access to safe foods. They also called for improved access to medications like epinephrine, especially in public places. In March, AAP leaders at the Annual Leadership Forum made reducing the cost of epinephrine auto-injectors one of their Top 10 resolutions.

“Pediatricians need to be aware of these disparities and work with low-income families to ensure that they can access specialty care and needed medications such as epinephrine,” authors said in the study. “They also need to provide families with an action plan detailing how to recognize a reaction and when and how to give epinephrine.”

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