Food insecurity, diabetes, and perceived diabetes self-management among Latinos in California: Differences by nativity and duration of residence

Abstract

We examined associations between food security (FS) status and type 2 diabetes (T2D) prevalence and perceived T2D self-management by nativity and US duration of residence among Latinos living in California. We used the California Health Interview Survey (2012–2017) and included Latinos who lived below 200% of the federal poverty line (n = 16,254) and for our management outcome, those with T2D (n = 2284). Latinos with low FS (OR = 1.44, 95% CI 1.14–1.83) or very low FS (OR = 1.87, 95% CI 1.33–2.61) had a higher odds of T2D compared to their food-secure counterparts. When stratified by nativity/duration in the US, US-born Latinos and Latino immigrants with >10 years duration had a higher odds of T2D if they reported low FS (US-born: OR = 1.60, 95% CI 1.02–2.52; >10 yrs: OR = 1.48, 95% CI 1.12–1.97) or very low FS (US-born: OR = 2.37, 95% CI 1.45–3.86; >10 yrs: OR = 1.78, 95% CI 1.15–2.76) compared to their food-secure counterparts. There was no association among immigrants with <10 years duration. For perceived T2D self-management, those with low or very low FS had lower odds of reporting proper management (OR = 0.56, 95% CI 0.36–0.86; OR = 0.46, 95% CI 0.26–0.83) compared to their food-secure counterparts. When stratified by nativity, the US-born did not differ in their perceived self-management by FS status, while immigrants with low or very FS had lower odds of perceived self-management (OR = 0.54, 95% CI 0.34–0.86; OR = 0.36, 95% CI 0.17–0.74), compared to their food-secure counterparts. Food insecurity may be an important contributor to T2D prevalence and perceived T2D self-management for Latino immigrants.