State-By-State Data for Food Allergy

Private insurance claim lines with diagnoses of anaphylactic food reactions rose 377 percent from 2007 to 2016, according to an analysis that FARE commissioned from FAIR Health, a national, independent, nonprofit organization that collects and analyzes data on healthcare costs. 

FAIR Health found that peanuts were the most common specifically identified food causing anaphylaxis, accounting for 26 percent of claim lines with anaphylactic food reaction. Tree nuts and seeds followed closely at 18 percent. Also common were egg allergies, crustacean allergies (e.g., allergies to shrimp or lobster) and dairy allergies, making up, respectively, 7 percent, 6 percent and 5 percent of claim lines. The most common category, however, was “other specific foods” (33 percent), which includes foods that less commonly cause allergies and cases in which the actual food allergen is not known. 

At FARE’s request, FAIR Health created 51 infographics—one for each state and Washington, DC—that opened a window on food allergy in each state during the period 2009-2016. 

For each state, FAIR Health showed graphically: 

• The top five foods that cause anaphylactic reactions; 
• The percentage of claim lines with an anaphylaxis diagnosis compared to the percentage with a history of food allergy diagnosis (for different food allergy groups); and 
• The percentage of food allergy claim lines by age group. 

FAIR Health also created two national heat maps, one for 2009 and one for 2016. The heat maps show how states compared to each other in their frequency of claim lines with anaphylaxis and history of food allergy diagnoses and shows, for each state, the percent change in the frequency of those diagnoses from 2009 to 2016. 

FAIR Health President Robin Gelburd stated: “Our data from the FAIR Health repository of billions of private healthcare claims contribute to understanding the state-by-state impact of food allergies. Though the specifics of food allergy diagnoses vary from state to state, it is clear that food allergies remain an important public health concern across the nation.”

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Geographic Patterns

In many states, claim lines with anaphylactic food reactions and history of food allergy diagnoses represented an increasing share of all medical claim lines from 2009 to 2016. The association between states and food allergy fluctuated over time. In 2009, the five states with the highest percentage of claim lines with food allergy diagnoses compared to all medical claim lines were (in order from highest) New York, Georgia, Colorado, North Dakota and Ohio. The top five states in 2016 were (in order from highest) North Carolina, North Dakota, New Jersey, Washington, DC, and Connecticut. Only North Dakota remained in the top five in both years.

Age

Different allergies were associated with different age groups. In the period 2007-2016, the age group 6-10 years accounted for 28 percent of all claim lines with peanut allergy diagnoses—but only 9 percent of all claim lines with food additive allergy diagnoses. Conversely, the age group 51-60 years accounted for 1 percent of claim lines with peanut allergy diagnoses, but 17 percent of claim lines with food additive allergy diagnoses.

Gender

In the period 2007-2016, claim lines with food allergy diagnoses were associated with boys more than girls from birth through age 18. However, for individuals older than 18 years the reverse was true: Food allergy claim lines were associated with women more than men.

Data Sources & Methodology

The Chartbook relies on analysis of FAIR Health’s proprietary in-house FAIR Health National Private Insurance Claims (FH NPIC®) database. As the nation’s largest collection of private healthcare claims data, FH NPIC® contains over 27 billion billed medical and dental procedures in claim records contributed by payors and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. 

Each of the individual “claim lines” — corresponding to a single medical service billed to an insurer — was reviewed to determine whether it included a diagnosis of food allergy or anaphylaxis due to an adverse reaction to food. Trends in diagnoses over the 2009 to 2016 period were analyzed, both at the national level and for each US state. 

Food allergies are commonly thought of as a childhood condition, but FAIR Health data show they are a broader issue. About two-thirds (66 percent) of all claim lines with diagnoses of history of food allergy from 2007 to 2016 were attributable to patients 18 years old and younger, but about a third (34 percent) were attributable to those over 18 years old. 

The increase in claim lines with diagnoses of history of food allergy from 2007 to 2016 was greater in rural (110 percent) than urban (70 percent) areas, FAIR Health data show. This finding is striking, given the common thinking that food allergies are much more of an urban than a rural problem.

About FAIR Health: FAIR Health is a national, independent, nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation’s largest database of private health insurance claims and is entrusted with Medicare claims data for 2013 to the present. FAIR Health collects, validates, organizes and packages its data using methodologies developed by academic experts. The data provide a detailed picture of healthcare cost and utilization in today’s marketplace.