Sociodemographic inequities in food allergy: Insights on food allergy
from birth cohorts
Abstract
A large and growing corpus of epidemiologic studies suggests that the
population-level burden of pediatric FA is not equitably distributed
across major sociodemographic groups, including race, ethnicity,
household income, parental educational attainment, sex). As is the case
for more extensively studied allergic disease states such as asthma and
atopic dermatitis) epidemiologic data suggest that FA may be more
prevalent among certain populations experiencing lower socioeconomic
status (SES), particularly those with specific racial and ethnic
minority backgrounds living in highly urbanized regions. Emerging data
also indicate that these patients may also experience more severe
FA-related physical health, psychosocial and economic outcomes relating
to chronic disease management. However, many studies that have
identified sociodemographic inequities in FA burden are limited by
cross-sectional designs that are subject to numerous biases, which can
reduce the epidemiologic utility of the resulting estimates. Compared to
cross-sectional study designs or cohorts that are recruited during
childhood, birth cohorts can offer advantages relative to other study
designs when investigators seek to understand causal relationships
between exposures occurring during the prenatal or postnatal period and
the atopic disease status of individuals later in life. Numerous birth
cohorts have been established across recent decades, which include
evaluation of food allergy-related outcomes, and a subset of these also
have measured sociodemographic variables that, together, have the
potential to shed light on the existence and possible etiology of
sociodemographic inequities in food allergy. This manuscript attempts to
survey the current state of this birth cohort literature and draw
insights regarding what is currently known, and what further information
can potentially be gleaned from thoughtful examination and further
follow-up of ongoing birth cohorts across the globe.