Food allergy referral patterns from 2013-2015 to 2016-2018 at Texas Children's Hospital

Background: Food allergy (FA) is a prevalent condition in the United States that can cause anaphylaxis. FA cases are becoming increasingly concerning in the United States, with rising trends in the pediatric population. However, increases have not been proportional across racial and/or ethnic groups, with studies that show rapid increases in minority populations. Objective: Due to this trend, we investigated if FA prevalence increased in patients at Texas Children's Hospital (TCH) based on race and gender. Methods: We retrospectively compared patients at TCH between the years 2013 and 2015 (time frame 1) and 2016 and 2018 (time frame 2). Patient FA history was diagnosed via medical diagnosis codes. Patients were stratified by gender and five race categories: Asian, black/African American (AA), Hispanic/Latino, non-Hispanic white, and "other." The prevalence of an FA was calculated by dividing the number of patients with an FA by the total number of patients seen at TCH within a given race, gender, and time frame. The χ² test was used, and two-sided p-values of <0.05 were considered statistically significant. Results: The prevalence of an FA at TCH significantly increased within each race and gender except for patients who self-reported as "other" race. Asian patients had the highest increase in FAs among all the races between the two time frames. Black/AA American patients also had a clinically significant increase, with FA prevalence increased by 1.5 times from time frame 1 to 2. The prevalence increased more for male patients (0.43%) than for female patients (0.28%). The increase for male patients was similar to the increase for blacks (0.46%). Conclusion: FA prevalence increased for all race and gender subcohorts except for those who identified as "other" race, with clinically significant increases noted in males, Asian, and black/AA populations. This increase in FA prevalence suggests that there may be children of specific racial or ethnic groups who are at an increased risk of developing an FA.