Perspective Food Allergies, Janis Goldiie

PERSPECTIVE FOOD ALLERGIES JANIS GOLDIE WHEN FOOD KILLS THE IMPACT AND MEANING OF FOOD ALLERGIES Goldie is the incoming Dean of Academic Programs at the University of the Arts in , Prior to this role , she was Professor and the Chair of the Communication Studies Department at Huntington University in , Canada . Her research on food and public health focuses on Canadian communication , including discourses of food allergies via popular culture artifacts , news media , or governmental sites , as well as the discourse that stakeholders use when considering food allergies . 342 FOOD ALLERGIES

Learning Outcomes After reading and discussing this text , students should be able to Explain the basic aspects of food allergies and their as a public health issue . Describe how food allergies are an important issue of sideration in the broader context of Food Studies . Identify elements of the impact and experience of those living with food allergies . INTRODUCTION What did you eat for lunch today ?

A sandwich ?

Perhaps some bannock or curry ?

Maybe a sushi roll or a taco or a slice of pizza ?

Did you think about the ingredients ?

How the food was pared ?

What oil or condiment was used ?

Did you consider that eating your lunch might harm you so severely that you would need immediate medical attention and , if not treated promptly , could even die ?

If these questions aren at the top of your mind before every time you you ably dont live with a food allergy . Food allergies occur when the immune system does not a food as safe and responds with an allergic A ous reaction , anaphylaxis , can manifest as a number of different effects , such as respiratory ( trouble breathing , chest pain , or throat tightness ) skin ( hives or swelling of the face or lips or tongue ) gastrointestinal ( nausea or vomiting ) or vascular ( dizziness or fainting ) among others . While reactions can range in severity , a food allergy is a chronic health condition , 2010 . JANIS GOLDIE 343

requiring ongoing medical attention and limiting the daily of those afflicted . Roughly million Canadians are affected by food allergies that can be deadly if treatment is In Canada , percent of adults and percent of children under the age of 18 now report having at least one food Peanuts , tree nuts , milk , eggs , mustard , fish , shellfish , sesame , soy , and wheat are the priority food allergens in Canada and are responsible for the majority of clinical ( See Table below for breakdown of by age and allergen in Canada . Food allergies are a ous and growing public health issue in Canada and much of the world . There has been a significant reported rise in food gies in the past two decades , with up to a 50 percent increase of prevalence for children since With prevalence at an time and no agreed upon explanation as to the cause and minimal treatment options available for the food allergic , food allergies are cause for . AllerGen 2017 . Ibid . Schwartz 2013 . et al . 2013 . 2018 . Clarke et al . 2020 et al . 2015 et al . 2015 . 344 FOOD ALLERGIES

FOOD ALLERGY PREVALENCE IN CANADIAN CHILDREN AND ADULTS ) mum rum Table This chart is a representation of data from national survey . See the complete table on the Allergen website . Alongside the increasing prevalence of food allergies , research on the subject has also increased over the last few decades . Living with a food allergy qualifies as a legal disability under the ter of Rights and Freedoms in Canada , including an obligation to accommodates Those with food allergies are frequently lied , socially isolated , economically challenged , and experience significant negative outcomes on their quality of life ( In this way , food allergies not only increase the risk of fatality for those most severely affected , they regularly disrupt life for those diagnosed and their families Given that eating is a constant and potentially lethal risk , the study of food allergies presents a unique and important perspective to consider within food ies . Whether examining the issue from a food systems , culture , justice , risk , feminist , or policy lens , the topic of food allergies provides an ample area for future study in the In the lowing section , some of the current findings in the research on food allergies are outlined . I then go on to discuss an area that . Murdoch et al . 2018 . Elliott . 2019 . JANIS GOLDIE 345

11 . 12 . 13 . is receiving greater consideration and cation or discourse of food allergies . CURRENT RESEARCH The Impact and Experiences of Food Allergies The majority of the research on food allergies to date is ical . Biomedical studies examine issues such as current sis options , prevention , treatment , and management strategies , as well as the epidemiology of food allergies and their In contrast , social science research on food allergies has focused on the experiences and effects of living with food gies . For example , recent studies on the economic costs with food allergies have found that the overall economic burden is substantial , both for those with food allergies as well as for healthcare In Canada , families with a member who has a food allergy reported higher direct annual costs of just less than 2400 ( on average ) largely attributed to increased spending on groceries and restaurant meals . also spent more travelling to medical appointments and on medications compared to families without a food While healthcare costs in Canada related to food allergies are only beginning to be tracked , the Canadian Institute for Health Information ( reported that between 2007 and 2014 , the total number of visits to the emergency departments for and allergy rose from to in and Other studies have examined billing fees from physicians for common allergy tests across Canada and have et al . 2021 Dixon et al . 2016 al . 2020 al . 2014 Warren et al . 2020 . et al . 2013 . Golding et al . 2021 . Information Canadian Institute for Health Information 2015 . 346 FOOD ALLERGIES

found that costs vary widely depending on the service and . 15 . Beyond the economic effects of living with a food allergy , there has also been a significant focus on the effects on and the lived experiences of the food allergic as well as their caregivers . This research includes examinations of the psychosocial and mental health impacts of living with food allergies , as well as daily management and . These studies show how all areas of life can be affected by food emotional , physical , and the food allergic and their family members . Everything from grocery shopping , meal preparation , school attendance , family and social activities , as well as social skills can be impacted . In addition , the effect on caretakers of children with food allergies , as well as the children themselves , can result in high levels of emotional tress and anxiety . Caregivers feel sadness , anger , guilt , worry , and uncertainty about food allergies in their children , and that their distress becomes worse if they have fewer emotional resources , younger children , or children with behavioural problems . 17 In addition to the effects on mental health , there are notable psychosocial effects . Living with a food allergy results in cant instances of social isolation , such as not being able to attend or participate in workplace , friend or family functions , rant outings , or even travel opportunities , which further affects For children , not being able to eat what others are ing , or even needing to eat alone , can be particularly ing in social settings such as schools , parties , and sports events . In addition , bullying is a noted problem for children with food allergies . Anywhere from 16 to 32 percent of children or teens 15 . et al . 2020 . 16 . Cummings et al . 2010 Shaker et al . 2017 Miller , et al . 2020 . 17 . Williams et al . 2009 et al . 2020 . 18 . al . 2012 . JANIS GOLDIE 347

19 . 20 . 21 . 22 . 23 . report having been teased or bullied because of their food allergy , often leading to negative psychological impacts such as sadness , depression , and decreased Other studies note the stigma surrounding food allergies and the challenges that go along with the consistent that management of a chronic health condition With regard to vulnerable groups , research has indicated that education , socioeconomic status , and race can affect the and management of food allergies . For example , income individuals in with food allergies reported difficulty obtaining safe food and medications due to medical misinformation , having to use food banks , or general Other studies have found that Caucasian children and those with higher income are more frequently provided a diagnosis than other while Aboriginal children have low rates of diagnosis and treatment for their food allergies as well as significant disparities in food allergy management related to Various other studies on food allergies have examined risk as well as behaviors , such as the conscious risks teenagers with food allergies are willing to take ( trying food without knowing the ingredients , not having their on hand , etc . in addition to management strategies and practices in schools and policies , to name just a few In all , the study of food allergies is a burgeoning area of focus with many facets . Fong et al . 2017 . 2011 . et al . 2014 . et al . 2011 . et al . 2013 . al . 2017 al . 2020 et al . 2018 . 348 FOOD ALLERGIES

Food and Communication The Discourse of Food Allergies In food studies , food is understood to be much more than just a means of survival . Food is sustenance , but it is also a symbol , a product , a ritual object , an identity badge , an object of guilt , a political tool , even a kind of 25 As , Sumner , and argue , What we eat , how we eat , when we eat , and with whom we eat reflect the complexity of our social , economic , political , cultural , and environmental relations with food Food has much meaning . As such , the combination of a studies approach and a food studies approach ( both fields emphasize and a critical perspective ) is a natural fit . 27 Connecting food and communication is a fairly recent move . The study of communication is concerned with understanding the ways in which humans share verbal and nonverbal symbols , the meanings of the shared symbols , and the consequences of the 28 Because food is a nonverbal symbol in so many ways , unpacking the meanings that we have around food and the sequences of those meanings is crucial to understanding food . Food is also a code , much like language , in that it expresses terns of social relationships , can be performative , and is directly linked to both ritual and In all of these ways , we use food to communicate with others and as a means of personal identity , group affiliation and disassociation , and other social categories , such as socioeconomic class so that food functions symbolically as a communicative practice by 25 . cited in KO et al . 2017 . 26 . et . 27 . Henderson 1970 . 28 . 2014 . 29 . Greene Cramer 2011 . JANIS GOLDIE 349

30 . 31 . which we create , manage and share meanings with 30 We use food in the construction and communication of our own personal identities , in our group associations , and our ability to share and discuss food across a wide variety of social sites and situations . our communication about food , which can be referred to as our food discourse , operates as important sites of struggle with significant social and political 31 Discourses around the local food movement , organic food , or dietary practices such as , for example , all point to social and political implications such as changes in production economic investments in 32 and consumption behaviours , resources , and government policies . When we understand that not just food and the ways we about food matter economically , politically , and socially , we start to ask questions about the ways issues such as food allergies are represented in talk , text , and media culture more broadly . We also start pay more attention to the implicit and explicit meaning of discourses around food allergies , and What they mean for how We develop resources and supports , approach treatments , management practices , policies , etc . While there is a great deal of research on food allergies , the focus on the various discourses of food allergies is only beginning to receive more attention . Examining how We communicate about food allergies can be undertaken in various discursive sites of text and talk across various . A few studies have begun to examine the course of food allergies within sites of media culture . For ple , looking at food allergy blogs , has investigated the ways that discourse the health risk as , xi . cited in Greene Cramer 2011 . 2016 2017 2012 . 350 FOOD ALLERGIES

an individual responsibility , centered on food consumption and choice . Further , she highlights that that responsibility is as a one , so that allergy is seen as the responsibility of women as mothers and as providers of food for their 33 Analysis on the framing of food allergy discourse in the news has pointed to the way that certain stakeholders frame issues differently . Advocates and affected individuals make moral judgments and suggest dies , while doctors diagnose the cause of food allergies or frame food policy Others point to the harmful effects of food allergies humorously in entertainment In a recent piece , for example , two short comedic media of food allergies were analyzed an episode of Television , in which one of the main characters has an anaphylactic reaction and a short skit from the Comedy Festival about food allergies in These media artifacts represent food allergies as something to be not taken seriously , even ridiculed . The food allergic are shown as weak and unable to survive or cope with life everyday challenges . Further , food allergies are represented as an individual in which the food allergic is responsible for the lem solely on their own . These messages matter , because like all discourse circulating in the public domain , they can inform our broader beliefs and behaviours , especially when certain representations persist and dominate . Its pervasiveness in North America as a machine means that media culture offers much social instruction about who we are and what our norms and values are in a society . The ways that food allergies are presented in our 33 . 11 . 34 . et al . 2012 2011 35 . Abo et al . 2017 Goldie 2019 . 36 . Ibid . JANIS GOLDIE 351

37 . popular media such as comic , news or social or entertainment texts , can thus how we feel , think about , or react to food allergies in our lives . If the messages we hear about food allergies on television , for example , tell us that ple with food allergies are weak and that food allergies are not an issue to take seriously , then it might relate to the policies that are created for schools or the bullying that exists for the food allergic . In all , while the study of the discourses of food allergies needs much more attention , it is an important step in the research on food allergies more generally . When we tie the research on the experiences of those living with , or caring for , the food allergic with research into the way we talk about , and thus understand food allergies , we are much better positioned to provide able and meaningful social impact . We must first assess how We understand the meanings behind food allergies in our cultures if we are to come to any sort of health or policy solutions . CONCLUSION The issue of food allergies is an important area of consideration within the broader field of food studies because of its increasing prevalence and the impacts it has on the daily lives of those affected . The study of food allergies also provides a valuable opportunity to examine an area of discourse of which the meanings imbued within a wide variety of talk and text and cement our understandings of disease , management strategies , support systems , and policies . We are used to thinking about food as a source of nourishment and identity , as well as for enjoyment and pleasure . But when the food one consumes poses a constant , everyday risk to ones life , there are very Weaver 2013 . et al . 2017 . 352 FOOD ALLERGIES

meanings imbued Within it . Understanding the different ways that food means is an important endeavour to continue to on in the Work of food studies . Discussion Questions Why is it important to connect food discourse to the broader field of food studies ?

Why do our meanings and language about food matter ?

Why do you think the research on food allergies has been slow to examine the communication around this health issue ?

What representations have you seen of food gies in media culture ?

Do you recall any scenes in popular films or television series in which a food allergy episode or reaction occurs ?

If so , what happened ?

How was the reaction portrayed ?

How was the person experiencing the reaction ?

What meanings about food allergies were constructed ?

Do these align with the experiences indicated by the academic research ?

Additional Resources Food Allergy Canada National Film Board , Sabrina Law , 2007 , available for free online streaming . JANIS GOLDIE 353 References Abo , Slater , and . 2017 . Using Health for Laughs and Health Policy Support The Case of Food Health Communication 32 ( Simons , and . 2020 . I Want to Really Crack This Nut An Analysis of Policy Needs Surrounding Food Public Health 20 ( Simons , Hurst , and . 2020 . Qualitative Analysis of Perceived Impacts on Childhood Food Allergy on Caregiver Mental Health and Annals of Allergy , Asthma Immunology Official Publication of the ican College of Allergy , Asthma , Immunology ( Clarke , Elliott , Pierre , La , and . 2020 . Temporal Trends in Prevalence of Food Allergy in The journal of Allergy and Clinical Immunology In Practice ( Cummings , A . Michel , mary King , Graham Roberts , and Jane Lucas . 2010 . Management of Nut Allergy Quality of Life and An ) in Children and Their Pediatric Allergy and Immunology 21 ( de Silva , Singh , Arshad , et al . 2020 . Preventing Food Allergy in Infancy and Childhood Systematic Review of Controlled 354 FOOD ALLERGIES

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