Association of Food Insecurity and Lack of Social Support in a Cohort of Inner-city Chronic Kidney Disease (CKD) Patients (P04-065-19)

Abstract

ObjectivesWe examined the association between social determinants including food insecurity and social support in a minority, ethnic population with CKD. MethodsA face-to-face survey was conducted in patients from an inner-city CKD (37), dialysis (23) and transplant clinic (31), including questionnaires to assess social support (MOS survey, scored 1–5, with 1 being poor support), perceived stress (PSS), and food security using the short form food security scale, with a score of 1–4 (very low to adequate). Patients were divided into adequate food security (score of 4) and inadequate food security (score of <4). Nutrition Literacy was assessed via the Newest Vital Signs toolkit (6 questions relating to a standardized food label). There were no differences in response among the clinics so they were analyzed together. ResultsThere were 39 (43%) men and 52 (57%) women with 75 black, 3 white, 3 Hispanic and 11 other. Mean age was 62.6 ± 14.0). 59 (54%) patients were foreign-born(mean time in the US 35.4 ± 16.2 yrs). 45% (36) had history of diabetes, and 84% (74) history of hypertension. Mean BMI was 29.5 ± 6.7. 30 pts (17.6%) scored <4 on the food security scale (FINS). There was no difference between food secure (FS) and FINS as regards age, place of birth, sex, marital status, prevalence of diabetes or hypertension, number of people in the household or SNAP participation. FINS were more likely to report income <$40 K/year (100% vs 62%, P < 0.001), with 83% reporting income <$20 K. They also had lower nutritional literacy (1.35 ± 1.7 vs 2.3 ± 1.8, P = 0.037), greater perceived stress (PSS 12.1 ± 5.7 vs 7.93 ± 7.2, P = 0.01), less social support, both tangible (people to help drive to appointments, prepare meals or do chores) score 3.43 ± 1.41 vs. 4.33 ± 1.0, P = 0.003, and emotional (someone to talk to, to give advice, that you trust, who understands your problems) score 3.55 ± 1.19 vs 4.23 ± 0.96, P = 0.02. ConclusionsIn our population: 1. Patients with inadequate food security were more likely to report extreme poverty and had lower nutritional literacy. 2. Patients with inadequate food security were more likely to report inadequate social support, both emotionally and tangibly, and greater perceived stress. 3. In this population with a high disease burden, the combination of food insecurity, perceived stress and poor social support may affect long-term outcome and should be investigated further. Funding Sourcesnone.