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The Role of Social, Economic and Environmental Factors in Food Allergy Disparities

社会、经济和环境因素在食物过敏差异中的作用

基本信息

批准号：
10515345
负责人：
Lucy A Bilaver
金额：
$ 16.02万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-11-01 至 2024-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10515345
关键词：
Accident and Emergency department Adult Affect African American Age Allergic Reaction Area Asian Atlases Black race Caring Characteristics Child Chronic Clinical County Data Data Set Diagnosis Disadvantaged Disparity Disparity in diagnosis District of Columbia Economic Burden Economic Factors Economics Emergency department visit Enrollment Environmental Risk Factor Epinephrine Ethnic Origin Family Food Food Hypersensitivity Geography Goals Guidelines Health Health Care Costs Health Expenditures Healthcare Systems Hospital Costs Hot Spot Hypersensitivity Income Institute of Medicine (U.S.)Intervention Knowledge Life Literature Low income Maps Measures Medicaid Methods Modeling Native Hawaiian or Other Pacific Islander Not Hispanic or Latino Outcome Outpatients Patient Self-Report Patients Phenotype Population Prevalence Privatization Probability Race Relative Risks Reporting Research Risk Role Source Specialized Foods Subgroup Surveys United States United States Department of Agriculture Universities Visit Wisconsin comorbidity cost ethnic disparity ethnic health disparity food environment food insecurity geographic disparity health care disparity income disparities insurance claims novel population health programs racial disparity racial minority social social factors study population

项目摘要

PROJECT SUMMARY AND ABSTRACT Background: Food Allergy (FA) is a potentially life-threatening chronic condition that affects approximately 32 million U.S. children and adults. While an estimated 7.6% of U.S. children have FA, African-American non- Hispanic children have a significantly elevated risk relative to non-Hispanic white children. Among children enrolled in the Medicaid program, race and ethnicity were associated with FA such that Asian, Black, and Pacific Islander/Native Hawaiian children had a higher odd of FA compared with white children. In addition, racial and income disparities have been observed in the economic burden of FA and in the likelihood of receiving guideline-based allergy care. Although evidence of disparities is growing, few studies have examined the source of disparities, especially modifiable factors such as features of the local food environment, and none have used large administrative data from privately insured children. Specific Aims and Methods: Theprimary aims of this study are as follows: 1)To measure racial and ethnic, income, and geographic disparities in FA diagnosis and management among U.S. children, 2) To assess the contribution of social, economic, and environmental factors to disparities, 3) To identify regional hot spots of FA diagnosis and management outcomes among U.S. children with food allergy. This study will leverage two complementary administrative data to examine disparities: the Medicaid and CHIP T-MSIS Analytic File (TAF) and the Health Care Cost Institute (HCCI) Commercial Claims Research Dataset. The study population in the TAF will include all children enrolled in the Medicaid program in at least 49 states and the District of Columbia. The HCCI data will include employer-sponsored insurance claims on approximately 11 million U.S. children ages 0-17 per year. County-level characteristics will be drawn from the University of Wisconsin Population Health Institute's County Health Rankings & Roadmaps and the USDA's Food Environment Atlas. The empirical approach will use the framework of racial and ethnic disparity put forth in the Institute of Medicine's (IOM) 2003 report, Unequal Treatment. Hypotheses and Expected Results: Our associating stores explain primary study hypotheses are based on a conceptual model risky food environments including t hose with high food insecurity and reduced access to grocery with poorer food allergy management. Specifically, we hypothesize that the food environment will a statistically significant percentage of the differences in FA diagnosis and management. Significance and Effects on Other Research: This will be the first study to systematically examine disparities in FA diagnosis and management among privately and publicly insured children and the first to leverage existing data to explore the impact of the food environment on disparities. The food environment represents a potentially modifiable target of intervention to ameliorate disparities in guideline-based allergy care and reduce unintentional allergic reactions.

项目总结与摘要