(1230) Evaluation of Sociodemographic Disparities in Allergy Testing: An All of Us Research Program Study

Introduction: To evaluate disparities in access to allergy testing across socioeconomic, racial, and ethnic groups

Methods: This cross-sectional study identified patients from the National Institute of Health All of Us database from 2018 to 2023. Patients diagnosed with allergic etiologies using ICD-9/10 codes (cohort 1) and patients who underwent allergy testing using CPT codes (cohort 2) were included. Univariate analyses and effect size calculations were performed to assess the impact of sociodemographic factors on access to allergy testing.

Results: Of the 75,104 patients with allergic diagnoses in cohort 1, 1.2% (N=936) underwent allergy testing. Patients who received allergy testing had significantly higher median income compared to those who did not receive allergy testing ($69K vs. $65K, respectively, p< 0.005, Cohen’s d=0.27). For cohort 2, delineated by N=1,536 patients who received allergy testing, 20% of patients received IgE testing (N=307), 26.7% received intradermal testing (N=410), and 78.1% received percutaneous testing (N=1200). Median income was significantly higher for those who received IgE testing compared to those who did not ($70.3K vs. $64.8K, p< 0.005, Cohen’s d=0.39). Among those who underwent IgE testing, 10.4% identified as Black compared to 68.7% who identified as White (p < 0.005, Cramer’s V=0.16). Proportion of patients without insurance was significantly lower for those who received percutaneous testing compared to those who did not (6.6% vs. 7.7%, p< 0.005, Cohen’s d=0.38). The proportion of patients reporting at least a high school education level was significantly higher for those who received percutaneous testing compared to those who did not (92% vs. 90.1%, p< 0.005, Cohen’s d=0.42).

Conclusions: Significant disparities in sociodemographic factors such as income, insurance status, race, and education level, impact access to allergy testing.