Impact of Food Insecurity on the Management of Children With Food Allergy: A Scoping Review

Child health and development are affected by food insecurity, which is an increasing phenomenon globally. The rates of food allergy are also increasing, and the multifaceted burden is well documented. The higher costs of allergen-free food, essential to food allergy management, may compound the levels of food insecurity, but evidence is still emerging. This scoping review was conducted with the aim to understand the impact of food insecurity on the management of children living with food allergy by mapping the current types of evidence, key concepts, and research gaps. Following JBI methodology, evidence about children aged ≤18 years living in high-income countries with any type of food allergy and food insecurity were included. A comprehensive strategy was used to search for published articles and unpublished papers. Articles were assessed for eligibility by 2 reviewers independently. Data were extracted and subject to basic numeric and qualitative content analysis. Overall, 56 articles were included, with the most frequent types being review articles (n = 11) and primary research studies (n = 11). All articles but 1 were published in the United States and Canada, and availability surged after the COVID-19 pandemic in 2020. Six concepts were identified: (1) prevalence of food insecurity; (2) food allergy-related quality of life; (3) influence of social determinants of health; (4) risk of adverse events; (5) healthcare and social interventions, and (6) multisector recommendations. No clinical standards, guidelines, or policies were found, likely due to the overall paucity of literature available. Gaps in the evidence included a lack of short- to long-term outcomes and consideration of a holistic view from a bio-psycho-socio-economic and multidisciplinary lens. Broader research and multiagency support across society are urgently needed for children experiencing food allergy and food insecurity.