Mental Illness, Not Weight Status, Predicts Increased Odds of Food Insecurity in the Health and Retirement Study (OR02-06-19)

Abstract

ObjectivesFood insecurity, or limited and/or uncertain access to adequate nutrition, is increasingly recognized as a determinant of clinical and psychosocial outcomes. While there is considerable research demonstrating an association between food insecurity and having obesity in children and young adults, little is known about this association in the elderly. In order to determine the association between weight status and food insecurity in older Americans, we proposed to examine a national cohort of elderly retirees. MethodsWe conducted an analysis of data from participants aged 65+ years from the Health and Retirement Study, a nationally representative cohort study of aging. We linked 2868 participants’ responses to a food insecurity assessment to their demographic characteristics, body mass index, and medical history, among others. Odds ratio estimates of food insecurity were computed. ResultsThe prevalence of food insecurity was higher among participants with overweight or obesity compared to leaner counterparts. However, weight status was not a significant predictor of food insecurity after adjusting for income, demographic covariates, lifestyle factors, comorbidities, and functional and cognitive status. Instead, a psychiatric diagnosis (OR 2.11, 95% CI 1.08, 4.15), self-report of depression (OR 2.12, 95% CI 1.20, 3.73), current smoking status (OR 1.73, 95% CI 1.11, 2.69), African American race (OR 3.03, 95% CI 1.54, 5.98), and other non-White race (OR 3.84, 95% CI 1.56, 9.45) were all independently associated with increased odds of being food insecure. ConclusionsHaving overweight or obesity was not associated with food insecurity in a cohort of elderly participants. Mental illness, however, either as a self-report of depression or a history of a psychiatric diagnosis, was associated with significantly increased odds of being food insecure, regardless of income. Mental health status, along with racial/ethnic identity and tobacco use should all be key considerations in future intervention studies aimed at addressing food insecurity in older populations. Funding SourcesThis study was supported by the Veterans Health Administration, Office of Research and Development. Supporting Tables, Images and/or Graphs▪▪▪▪▪