The Psychosocial Burden of Pediatric Food Allergy in the United States: A Population-Based Survey

Background: Food allergy (FA) affects approximately one in 12 US children, with prevalence increasing. Aside from considerable health care utilization, accumulating research suggests heightened psychosocial burden among this population.

Objective: To characterize FA-related psychosocial burden among a large, nationally representative pediatric sample, and its correlates, including sociodemographic characteristics, comorbid conditions, allergy severity, allergic symptoms, number and type of allergens, and healthcare utilization.

Methods: A survey was administered between October 2015 and September 2016 to a nationally representative sample of US households. Survey constructs included the Food Allergy Independent Measure (FAIM), which was developed to quantify adverse impacts of living with FA on psychosocial burden (range = 1-7; higher scores indicate greater burden). FAIM responses were analyzed from caregivers reporting current FA in their child (N = 4734). Linear regression models examined associations with sociodemographic and FA characteristics.

Results: The overall estimated mean caregiver-proxy FAIM scores for the US pediatric population were 2.79 (SE = 0.03) for reported FA, 2.96 (SE = 0.04) for convincing FA, and 3.21 (SE = 0.05) for physician-confirmed, convincing FA. Significant differences in caregiver-reported burden (p < .05) were found for sociodemographic (i.e., household income, birth country, child age), and clinical (i.e., FA severity, physician diagnosis, specific allergens) factors.

Conclusion: While heterogenous to a degree, the psychosocial burden of children with FA was substantial irrespective of sociodemographic and clinical characteristics. FAIM norms can be used clinically, as well as be leveraged by other economic, epidemiological, and health efforts to understand the public health impact of FA.