Food insecurity and allergic diseases: A call to collective action

Authors: JONES, STACIE - University Arkansas For Medical Sciences (UAMS); ANVARI, SARA - Baylor College Of Medicine; COLEMAN, AMAZIAH - National Instiute Of Allergy And Infectious Diseases (NIAID, NIH); PESEK, ROBERT - University Arkansas For Medical Sciences (UAMS); KLOEPFER, KIRSTEN - Indiana University Of Pennsylvania; PERRY, TAMARA - University Arkansas For Medical Sciences (UAMS); JEFFERSON, AKILAH - University Arkansas For Medical Sciences (UAMS); DOAN, DIEU - University Arkansas For Medical Sciences (UAMS); ANDRES, ALINE - University Arkansas For Medical Sciences (UAMS); DODERER, MARCY - Arkansas Children'S Hospital; HILBUN, ASHLIE - Arkansas Children'S Hospital; SOLOMON, RYAN - Arkansas Children'S Hospital; SCURLOCK, AMY - University Arkansas For Medical Sciences (UAMS)

Submitted to: Journal of Allergy Clinical Immunology
Publication Type: Review Article
Publication Acceptance Date: 10/24/2023
Publication Date: 2/5/2024
Citation: Jones, S.M., Anvari, S., Coleman, A., Pesek, R.D., Kloepfer, K.M., Perry, T.T., Jefferson, A.A., Doan, D., Andres, A., Doderer, M., Hilbun, A., Solomon, R., Scurlock, A.M. 2024. Food insecurity and allergic diseases: A call to collective action. Journal of Allergy Clinical Immunology. 153(2):359-367. https://doi.org/10.1016/j.jaci.2023.10.019.
DOI: https://doi.org/10.1016/j.jaci.2023.10.019

Interpretive Summary: Over 10% of Americans are food insecure - uncertain about their access to adequate food. Food insecurity is a key social determinate of health, known to negatively affect nutrition and health outcomes. To allergy and immunology patients who may have to adhere to specialized diets, the impact of food insecurity can lead to ineffective medical care. Prominent allergy and nutrition investigators, including ACNC and ACRI faculty, recently published a call to action for government, community organizations, schools, and healthcare providers outlining ways food insecurity impacts people with life-threatening food allergies, digestion disorders, and asthma, along with the long term-consequences of a society living with nutritional deficiency. Outlined were strategies that assist communities impacted by food insecurity gain access to nutritious food as part of their routine lifestyle, to promote health equity and optimize health outcomes. Efforts to address food insecurity through hospital systems and NIH Funding, such as identifying at risk families for preventative programs, have significantly contributed to short-term needs, however, strategies allowing long-term access to safe and nutritious foods in their communities is necessary. Collectively, allergy and immunology specialists along with all treating clinicians must leverage their unique roles to advocate for and help develop strategies that promote a nutrition-secure environment. To consider the unique needs of vulnerable populations at risk for food insecurity we need to create an inclusive, nutrition-secure environment for all, including allergy and immunology patients and their families, via cross-sector partnerships with health care providers, hospitals and health care systems, policy makers, researchers, funding agencies, and advocacy groups.

Technical Abstract: Food security encompassess the concept of access by all people at all times to enough food for an active, healthy life. Conversely, food insecurity (FI) refers to household-level economic and social conditions of limited or uncertain access to adequate food. FI is a key social determinant of health that can negatively affect nutrition and health outcomes, as it is estimated that 10.2% of the US population meets criteria for FI. Recognizing the impact of FI on our patients and families is critical to promote health equity and optimize health outcomes. This review focuses on FI and allergic disease from the perspective of key multisector stakeholders within the field of allergy and immunology as well as from the larger health care arena, highlighting key resources and initiatives important to patients. Collectively, as specialists in allergy and immunology, and within the medical field more broadly, we must leverage our unique roles as we interface with patients and families and serve as committed advocates for change. Developing innovative strategies to promote health equity can provide a pathway forward for all children, adults, and families to gain access to healthy, nutritious food as part of their routine lifestyle. This is a call to action. (J Allergy Clin Immunol 2024;153:359-67.)