We’re in a rapidly growing food allergy epidemic. 1 in 13 American children have food allergies—a number that’s only growing. Private insurance claims of anaphylactic food reactions, which are severe and potentially life-threatening, rose 377 percent from 2007 to 2016. Yet despite their increased prevalence in recent years, one thing hasn’t changed: Undermining the very real risks and anxieties associated with living with food allergies.
Beyond the risk of anaphylaxis, food allergies can affect quality of life—especially in children and their families—in myriad ways. Simple activities like meal preparation, dining out, and socializing at birthday parties or extracurricular activities become arduous tasks demanding extra precautions. The economic impact of food allergies can also be significant due to the cost of special foods, treatments, and medical visits. Food allergies are more prevalent in Black and Asian populations, exacerbating health disparities.
Compounding these daily challenges is another psychosocial challenge: The bullying and harassment faced by people with food allergies, especially children and teens. In 2018, the Washington Post reported that three high schoolers faced criminal charges after knowingly exposing a classmate to a known food allergen during lunch. One year earlier, a Central Michigan University student pleaded guilty to smearing peanut butter on the face of an unconscious student who had a peanut allergy.
Incidents like these highlight the widespread failure to understand the dangers of food allergies which often stems from one key misconception: Food allergies are not preferences. They are a legitimate health care concern that are part of a growing public health crisis, and they deserve to be treated as such.
What can we all do to better advocate for people with food allergies? The 2008 amendment to the American Disabilities Act protected conditions that show symptoms only at certain times, including allergies, but more needs to be done.
More recently, the Food Allergy Safety, Treatment, Education, and Research (FASTER) Act, effective since January 1, 2023, adds sesame to the list of major food allergens. However, some businesses have responded not with limiting cross-contamination but by intentionally adding sesame to foods that previously did not contain it—a move that’s been met with appropriate criticism from senators across the country. Bakeries and other food production sites must take efforts to prevent cross-contamination so that common foods like bread are easily available for those with sesame allergies.
Just as life-saving automated external defibrillator machines—which can help re-establish heart rhythm in someone undergoing sudden cardiac arrest—are located in public venues, epinephrine autoinjectors should be easily accessible as well. Now that most states have passed legislation regarding storing stock epinephrine in K–12 schools, auto-injectors should also be supplied in other public places.
Given the low rate of access to epinephrine among college students, this medication should be readily available in university buildings, including dining halls, dorms, and instructional spaces. Similarly, many airlines stock vials of epinephrine, which, unlike auto-injectors, are not easy to use, poorly labeled, and often require the expertise of a medical professional. When 35,000 feet in the air, we cannot rely upon the hope that someone adept at medical treatment will be on board. Having easy-to-use autoinjectors on every airplane ensures that a passenger undergoing anaphylaxis can be administered this time-sensitive medication as opposed to waiting for further treatment on the ground.
Finally, while food allergy research has expanded rapidly in recent years, leading to the development of new oral immunotherapies, there is still no cure. The National Institutes of Health faces a tight budget, which the Association of American Medical Colleges has stated falls short of the funding needed to promote therapeutics across medicine. An increased allocation of money for research will enable the development of innovations across health care, including food allergy.
The Consortium of Food Allergy Research (CoFAR) should also be further supported. Established in 2005, the Consortium has been continuously funded by the National Institute of Allergy and Infectious Diseases, which awarded CoFar $42.7 million in 2017 to maintain operation until 2024. CoFAR should be renewed at the end of this term to ensure the advancement of therapies currently in early research phases.
For people with food allergies, their journey ahead can seem long and daunting. But by treating it with the seriousness it deserves, we can provide them with support to feel safe while participating in society and improve their overall quality of life.
David R. Stukus is a pediatric allergist and can be reached on Twitter @AllergyKidsDoc. Anushree Vashist is an undergraduate student.
