Food Security, Utilization of Food Assistance Programs, and Caregiver Perceptions of Food-Induced Anaphylaxis Risk in Children with Food Allergies

This study provides a preliminary investigation of food insecurity (FIS), food assistance program utilization (Supplemental Nutrition Assistance Program [SNAP], food banks), and history of food-induced anaphylaxis (FIA) in children with Food Allergy (FA). Pediatric FA affects 4% to 8% of US children. FIS is the uncertainty or inability to meet family food requirements. We expected that children of FIS families would be more likely to have history of FIA due to limited control over food selection. Caregivers (n=183; 50% mothers) of children with history of physician-diagnosed FA (57% male; M-Age=7.5 years; 67% white, 22% black, and 21% Latino) completed an online survey. Key variables included demographics, perceptions about FIS, and history of child FIA. Caregivers classified as FIS reported increased perceived risk of accidental ingestion ((2)=11.99, P=0.001, phi=0.27; 41% versus 17%), severe reaction ((2)=6.24, P=0.01, phi=0.20; 45% versus 24%), and death ((2)=22.55, P<0.001, phi=0.36; 38% versus 12%). FIS status was associated with child history of FIA ((2)=5.54, P=0.02, phi=0.19) and utilization of food assistance programs ((2)=39.31, P<0.01, phi=0.46; 52% versus 8%) and food banks ((2)=183)=37.99, P<0.01, phi=0.46; 74% versus 28%). No differences between FIS and non-FIS caregivers were observed for income, ethnicity, or age. Surprisingly, no associations were observed between FIS status and demographics. Differences in perceptions of FA-related risks may reflect the challenges these families face to meet basic nutritional needs. Findings may also reflect experiences specific to FA, such as the economic burden of obtaining FA-safe foods; access to FA-safe foods; and FA-related anxiety. Future research is needed to examine FA risks and the impact of FIS on nutritional status.