Wednesday, August 23, 2017

Analysis shows big increase in diagnoses of food allergies, especially in rural children

A new analysis of private insurance claims shows that more people are suffering from allergies these days, and that those allergies are more severe especially in rural areas. The analysis was conducted by the nonprofit organization FAIR Health, which maintains a database of billions of medical and dental claims from 150 million people with private insurance. The search showed that anaphylactic reactions, especially to peanuts, have increased by almost five times from 2007 to 2016. Anaphylaxis is a systemic allergic reaction that can be fatal if not treated quickly.

An interesting result of the analysis was that there was a larger increase in claims from rural areas than in urban or suburban areas. Though both urban and rural allergy-related claims decreased in 2016, rural claims increased 110 percent while urban claims increased 70 percent over the entire 10-year period. That is intriguing because numerous studies have shown that children growing up in rural areas are less prone to allergies, possibly because the increased exposure to nature gives their immune systems a workout and makes them less likely to react to environmental triggers such as peanuts or eggs.

FAIR Health Inc. chart; click on it to enlarge it.
The analysis doesn't examine whether rural residents had increased rates of private health insurance coverage over that time period, and if so, how that affected the incidence of insurance claims. The rural rate climbed above the urban rate in 2014, the first year that the Patient Protection and Affordable Care Act was in full effect. FAIR Health plans to release a white paper in October examining "geographical and gender variations and costs of services, among other factors," Sumathi Reddy reports for The Wall Street Journal.

Experts have plenty of theories about the cause of the increase and severity of allergies. "The increase could be related to the increasing use of antibiotics, rising rates of Caesarean sections that affect the microbiomes of babies, and an increasingly sterile environment, says Hugh Sampson, director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York City. All have altered the good bacteria in our intestinal tracts, which alters the programming of our immune systems," Reddy reports. Sampson says another problem is that parents have been told to avoid giving highly allergenic foods such as peanuts to small children, an approach that appears to have backfired. Allergies to peanuts and tree nuts have at least doubled in the U.S. over the past 20 years.

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