{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T05:52:04Z","timestamp":1782885124776,"version":"3.54.5"},"reference-count":32,"publisher":"Oceanside Publications Inc.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Although disparities in food allergy (FA) related emergency department (ED) use exist, social context factors are understudied and may play an important role.\n                    <jats:bold>Objective:<\/jats:bold>\n                    We sought to evaluate the role of food security and community resources\n in explaining disparities in FA-related ED usage.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Electronic medical record data from Hasbro Children\u2019s Hospital\u2019s FA clinic were extracted from January 1, 2016, to December 31, 2021, for children ages &lt; 18 years. Diagnostic classification codes\n and chart reviews were used to identify encounters with immunoglobulin E (IgE) mediated FA-related diagnoses. We evaluated the differences in FA-related ED use by age, race and\/or ethnicity, community resources (Child Opportunity Index [COI]), and the percentage of households in the census\n tract that receive Supplemental Nutrition Assistance Program (SNAP) benefits. Logistic regression was performed to identify predictors of FA-related ED use.\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 1,512 children were seen at the FA clinic for IgE-mediated FA. Those who used the ED for FA were\n non-Latino White (NLW) (16.1%), Black (22.0%), Latino (23.1%), and Other (23.5%) (standardized mean difference [SMD], 0.10; p\u2009&lt;\u20090.05). The risk of FA-related ED visits differed by age, with fewer visits for older children (odds ratio [OR], 0.7), and by social economic and\n neighborhood environment variables, with a lower risk of ED visits for more resourced environments (ORs for public insurance, 1.57; OR for SNAP, 1.19; and OR for COI, 0.80). Disparities in ED usage became negligible for patients already connected to routine allergist care, which demonstrated\n a potential protective factor.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Black and Latino children have an increased risk for FA-related ED visits compared with NLW children, although social contextual factors explained most of the disparities. Analysis of the findings demonstrates the need to consider\n the social economic and neighborhood environment in FA management to inform place-based interventions.\n                  <\/jats:p>","DOI":"10.2500\/aap.2026.47.260030","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:30:30Z","timestamp":1782361830000},"page":"253-263","source":"Crossref","is-referenced-by-count":1,"title":["Social context factors and disparities in emergency department use in pediatric food allergy"],"prefix":"10.2500","volume":"47","author":[{"given":"Cynthia A.","family":"Esteban","sequence":"first","affiliation":[{"name":"From the Bradley Hasbro Children\u2019s Research Center, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace K.","family":"Cushman","sequence":"additional","affiliation":[{"name":"From the Bradley Hasbro Children\u2019s Research Center, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saksham","family":"Chandra","sequence":"additional","affiliation":[{"name":"From the Bradley Hasbro Children\u2019s Research Center, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M.","family":"Scarpaci","sequence":"additional","affiliation":[{"name":"Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Barker","sequence":"additional","affiliation":[{"name":"From the Bradley Hasbro Children\u2019s Research Center, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth L.","family":"Mcquaid","sequence":"additional","affiliation":[{"name":"From the Bradley Hasbro Children\u2019s Research Center, Rhode Island Hospital, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"e20181235","DOI":"10.1542\/peds.2018-1235","article-title":"The public health impact of parent-reported childhood food allergies in the United States","volume":"142","author":"Gupta","year":"2018","journal-title":"Pediatrics"},{"key":"B2","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.jaip.2016.10.006","article-title":"Racial differences in food allergy phenotype and health care utilization among US children","volume":"5","author":"Mahdavinia","year":"2017","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B3","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.anai.2022.12.017","article-title":"Proposed solutions by the American College of Allergy, Asthma, and Immunology and advocacy experts to address racial disparities in atopic dermatitis and food allergy","volume":"130","author":"Corbett","year":"2023","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B4","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.jaci.2013.12.006","article-title":"Access to health care and food in children with food allergy","volume":"133","author":"Johns","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"B5","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/tbm\/ibz059","article-title":"Food insecurity and caregiver perceptions of food allergen risk by food purchase location in children with food allergies","volume":"9","author":"Tackett","year":"2019","journal-title":"Transl Behav Med"},{"key":"B6","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jaip.2021.08.005","article-title":"Access to allergen-free food among Black and White children with food allergy in the FORWARD Study","volume":"10","author":"Coleman","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B7","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.jaip.2021.10.065","article-title":"Geospatial analysis of social determinants of health identifies neighborhood hot spots associated with pediatric intensive care use for life-threatening asthma","volume":"10","author":"Grunwell","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B8","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jpeds.2017.08.007","article-title":"The Child Opportunity Index and disparities in pediatric asthma hospitalizations across one Ohio metropolitan area, 2011-2013","volume":"190","author":"Beck","year":"2017","journal-title":"J Pediatr"},{"key":"B9","article-title":"Centers for Medicare & Medicaid Services (U.S.); National Center for Health Statistics (U.S.). 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