Association Between Food Insecurity and Food Allergy Among Low- to Middle-Income Households in China: A Cross-Sectional Survey Across Three Provinces.

Food allergies and food insecurity are significant yet understudied public health concerns in China. Understanding the association between the two is vital to developing integrated public health strategies to improve the nutritional status of the population. This study aimed to investigate the association between household food insecurity and food allergy among low- to middle-income households in China. In this online survey study across three provinces in China, we analyzed data from 4795 households headed by middle-aged adults. The association was analyzed using logistic regressions, adjusting for socioeconomic characteristics. In the overall survey sample, the prevalence of household food insecurity was 29.1%. Compared with food-secure households, households with moderate food insecurity (aOR = 2.70, 95% CI: 2.20-3.29) and severe food insecurity (aOR = 3.34, 95% CI: 2.47-4.52) had a higher likelihood of having food allergies. Among households including members with food allergies, food insecurity was associated with higher odds of allergy-induced hardships. We found a graded association between food insecurity levels and food allergy, with food insecurity exacerbating the burdens of allergy management. The findings underscore the need for integrated policies that improve access to affordable, allergen-free food in China. PRACTICAL APPLICATIONS: This study highlights that low-income households managing food allergies often struggle to afford safe, allergen-free foods. Policymakers can use these findings to design subsidy programs for hypoallergenic products and to develop affordable, allergen-free alternatives. These efforts could help reduce financial strain and improve health outcomes for food-allergic individuals in resource-limited families.