Food Security and Use of SNAP Benefits in Inner-City Patients with Diabetes: Associations with Gender, Social Support and Stress (P04-064-19)

Abstract

Abstract Objectives We examined prevalence and impact of food insecurity and use of SNAP benefits in a cohort of inner-city patients with diabetes. Methods 57 patients with diabetes from the CKD, Transplant, Dialysis, Diabetes, and Internal Medicine Clinics at an inner-city hospital were interviewed by face-to-face technique. Food security was assessed using the U.S. Adult Food Security Survey Module and scored from 1–4 (1–2 is food insecure, 3 is at risk). 24-hour food recall was evaluated using ASA24 software. Stress was assessed using the PSS stress scale. Results Mean age was 67.3 ± 10.87 yrs, with 21 men (36%), 36 women (64%), 82% black or African American, 61% high school education or less and 81% had household income < $40k/yr. Months since diabetes diagnosis ranged from 3 to 804 (mean 204.1 ± 148.99). 16% (8/50 respondents) were food insecure (score 1–2) and another 28% (14/50) were at risk (score 3). 42% (21/50) received SNAP benefits. There was no significant difference in macronutrient intake, total fruits, total vegetables, or added sugar intakes for food secure (FS) vs food insecure or at risk pts (FIS), and no significant difference in BMI, blood pressure, total cholesterol, HbA1c, or serum albumin. FIS patients scored significantly higher on PSS than FS (12.69 ± 4.5 vs 7.1 ± 7.4, P = 0.012). Patients receiving SNAP benefits were more likely to be FIS (2.9 ± 1.12 vs 3.59 ± 0.68, P = 0.01), more likely to be women (55% (18/33) vs. 17% (3/17, P = 0.012), report income < 25 K annually (68% (17/25) vs 12% (2/16), P = 0.006) and be single, divorced or widowed rather than living with a partner or married (64% (18/28) vs 14% (3/22), P = 0.001). Conclusions In our population of Inner-City patients with diabetes: 1. Over one quarter reported being at risk or food insecure. 2. At risk or food insecure pts scored significantly higher on the perceived stress scale. 3. Patients receiving SNAP benefits were more likely to be at risk or food insecure. 4. Patients receiving SNAP benefits were more likely to be severely indigent, female and living alone. 5. Although we did not find differences in nutrient intake on 24 hour recall, our data suggest that patients with diabetes who are food insecure and especially those who are receiving SNAP benefits feel social stress and are high risk over the long term as they also lack social and financial support to help deal with their chronic illness. Funding Sources none.