Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
National Institutes of Health, National Institute of Allergy and Infectious Diseases, Rockville, Md.
J Allergy Clin Immunol Pract. 2024 Mar;12(3):570-577. doi: 10.1016/j.jaip.2024.01.026. Epub 2024 Jan 25.
Social determinants of health can lead to poor health outcomes for food-allergic patients, including limited access to allergen-free foods and specialty care. Housing and transportation limitations can worsen social factors including food insecurity, poor early food introduction, increased reactivity to foods, lower tertiary/allergy care utilization, and increased emergency department utilization. A key component of addressing health equity involves valuing all people with sustained, focused efforts to address social determinants of health. In this clinical commentary, we discuss the current state of heath equity for food-allergic patients, highlighting the disparities in emergency care, food allergy prevention, and food insecurity. Solutions to improve health equity through clinical practice are proposed. Currently available funding opportunities through the National Institutes of Health for health equity initiatives are outlined. Gaps in health equity for food-allergic patients include the lack of documented successful implementation of effective solutions to food insecurity, poor early food introduction uptake, poor access to specialist care, and unequal distribution of educational resources. The availability of research funding and legislative policies supporting access to food and education bolster the impetus to move toward health equity for 20 million people in the United States with food allergy.
社会决定因素可能导致食物过敏患者健康状况不佳,包括获得无过敏原食物和专科护理的机会有限。住房和交通限制会使社会因素恶化,包括粮食不安全、早期食物引入不足、对食物的反应增加、三级/过敏护理利用率降低以及急诊利用率增加。解决公平问题的一个关键组成部分是重视所有的人,通过持续、集中的努力来解决健康的社会决定因素。在这篇临床评论中,我们讨论了食物过敏患者的健康公平现状,重点介绍了急诊护理、食物过敏预防和粮食不安全方面的差异。提出了通过临床实践改善公平的解决方案。概述了美国国立卫生研究院(NIH)目前为健康公平举措提供的资金机会。食物过敏患者的公平差距包括缺乏记录在案的成功实施解决粮食不安全问题的有效方法、早期食物引入率低、获得专科护理的机会有限以及教育资源分配不均。研究资金的可用性和支持获取食物和教育的立法政策为推动美国 2000 万食物过敏患者实现健康公平提供了动力。