Abstract P471: Association of Food Insecurity With Premature Mortality and Life Expectancy in the United States

Abstract

Introduction: Food insecurity has been linked to multiple causes of disease and mortality; however, its relationship with life expectancy by sex, and across racial and ethnic groups remains unknown in the US. Hypothesis: Associations of food insecurity with all-cause premature mortality and life expectancy may vary by racial and ethnic, and sex in US adults. Methods: We included 57404 adults who participated in the NHANES 1999-2018, with linkage to the National Death Index through December 31, 2019. Levels of food security were assessed with the US Department of Agriculture Adult Food Security Survey Module (full, marginal, low, and very low). Results: During a median of 9.3 years of follow-up, 4263 premature deaths were documented. Compared with the full food security group, the adjusted Hazard Ratios (HRs) were 1.50 (95% CI, 1.31-1.71), 1.44 (1.24-1.68) and 1.81 (1.56-2.10) across marginal, low, and very low food security groups, respectively ( P -trend < 0.001). The corresponding life expectancy at age 50 in each group was 32.5 (95% CI, 32.4-32.6), 29.9 (28.9-30.9), 30.0 (28.9-31.0), and 28.0 (26.8-29.2) years. Equivalently, adults with marginal, low, or very low food security lived on average 2.6 (95% CI, 1.5-3.7), 2.5 (1.4-3.7), or 4.5 (3.2-5.8) years shorter at age 50 years, respectively, compared with those with full food security. The associations appeared to be stronger in women than in men, and stronger in White adults than in Black and Hispanic adults (All P -interaction<0.05). Conclusions: Although the relation of food security and life expectancy varied across sex, racial and ethnic groups, overall, lower levels of food security are related to a higher risk of premature mortality and a shorter life expectancy.