Food Insecurity Disparities Research Articles

Disparities in Food Insecurity and Academic Achievement Among California Public University Students: An Intersectional Approach

Background/Objectives: Historically racialized status (HRS) and low socioeconomic position (SEP) are independent risk factors for food insecurity and poor academic achievement among college students. Despite increased enrollment of students from historically racialized groups and low SEP, little is known regarding the intersectional experience of these contemporary student characteristics with food security status or academic achievement. The purpose of this study was to examine the intersections of racialized status and SEP with food insecurity and academic achievement among undergraduate students attending a public university system in California. Methods: This cross-sectional study included 1170 undergraduates who utilized their campus food pantry between June and August 2019 at nine University of California campuses. Racialized status and SEP were used to construct four distinct intersectional positions: (1) White, not low SEP (i.e., traditional students; reference), and three contemporary student groups: (2) White, low SEP; (3) HRS, not low SEP; and (4) HRS, low SEP. Using regression analyses, these intersectional positions were examined with food insecurity and grade point average (GPA), while controlling for other student characteristics. Results: HRS, low SEP students had significantly higher odds of experiencing food insecurity (OR = 2.72; 95% CI: 1.52–4.97) and lower GPA (B = −0.14, p = 0.05) than traditional students, after adjustment. Conclusions: Contemporary students are at increased risk of food insecurity and lower academic achievement compared to traditional students.

Correlates of food insecurity among university students in a low socioeconomic area

Abstract Background The prevalence of food insecurity (FI) is high and suggested to be growing among university students, with potential detrimental effects on their health status and academic performances. This cross-sectional study aims to identify the socioeconomic, demographic and lifestyle factors associated with FI among university students in a disadvantaged area. Methods An anonymous online survey was conducted from Nov 2022 to Jan 2023 among students enrolled at University Sorbonne Paris Nord, located in a low socioeconomic area in France. FI was assessed with one question distinguishing 2 levels of FI: quantitative (i.e. not having enough to eat) and qualitative (i.e. not having the desired food). This abstract focused on quantitative FI. To improve the representativeness of the sample compared to the total student population of the university, sample weights were used according to gender, study level and speciality, whether they were undergoing initial training or not, or obtained their baccalaureate abroad or not. Multivariable multinomial logistic regression models were used to identify factors associated with FI. Results A total of 5068 students provided valid answers (20% of the target population), 66% of whom were women, and 12% and 36% reported quantitative and qualitative FI, respectively. Being a man, an undergraduate, having obtained a baccalaureate abroad, not living in the family home, not receiving food from family, having no household food-heating facilities, reporting financial difficulties, relying on food charity and eating alone on a regular basis were positively associated with quantitative FI (P < 0.0001). Those reporting quantitative FI were more likely to report academic difficulties. Conclusions This study shows a high prevalence of FI in this student population and identifies several associated factors. Identifying students at greater risk of FI is an important first step to design and evaluate public health interventions. Key messages • The different socio-economic backgrounds of university students imply important food insecurity disparities among them. • University students present several factors associated with food insecurity, which should be considered when addressing food insecurity in this population.

Urban-Rural Disparities in Food Insecurity and Weight Status among Children in the United States.

Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban-rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 with three age groups of children (2-5, 6-11, and 12-17 years old), the associations of weight status and child and household food security status by urban-rural residence were examined using Rao-Scott Chi-square tests. Statistical significance was set at p < 0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6-11 years. The associations between children's weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs.

Food insecurity and mental health among US adults during the COVID-19 pandemic: Results from National Health Interview Survey, 2020–2021

ObjectiveTo examine socio-demographic disparities in food insecurity during the COVID-19 pandemic and the association between food insecurity and mental health among US adults overall and communities vulnerable to food insecurity. MethodsA cross-sectional study was conducted using the 2020–2021 National Health Interview Survey of 57,456 US adults. Weighted multivariable logistic regression models were used to estimate the association between food insecurity and anxiety or depression symptoms in overall US adults and subgroups including young adults (18–34 years), females, Hispanic people, non-Hispanic Black people, individuals with prior COVID-19 infection, the unemployed, low-income participants, participants with children, and Supplemental Nutrition Assistance Program (SNAP) participants. ResultsYoung or middle age, female sex, Hispanic/non-Hispanic Black/other race/ethnicity, lower education level, unmarried/other marital status, unemployment, being below the federal poverty level, and greater number of persons in the household were associated with food insecurity (AOR ranged from 1.35 to 2.70, all p < 0.05). Food insecurity was independently associated with anxiety (AOR = 2.67, 99 % CI: 2.33, 3.06) or depression (AOR = 3.04, 99 % CI: 2.60, 3.55) symptoms in the overall adults. Significant associations between food insecurity and anxiety or depression symptoms were also observed in all subgroups (AOR ranged from 1.95 to 3.28, all p < 0.0001). Compared with overall adults, the magnitude of the association was greater for participants with children, females (for depression only), and non-Hispanic Black people (for depression only). LimitationsThe cross-sectional design prevents inference of causality. ConclusionsComprehensive policies are needed to ensure accessible and affordable food resources to reduce disparities in food insecurity and improve mental health, especially for those socioeconomically disadvantaged communities.

The Economic Impacts of COVID-19 on Autistic Children and Their Families.

We used data from the National Survey of Children's Health to (1) examine differences in economic hardship and safety net program use after the implementation of federal relief efforts, and (2) assess whether the COVID-19 pandemic exacerbated autism-based disparities in hardship and program use. We examined five dimensions of economic hardship (poverty, food insecurity, medical hardship, medical costs, and foregone work) and four safety net programs (cash assistance, Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and free or reduced-cost meals). First, we calculated adjusted prevalence and odds ratios to compare pre-COVID (2018-2019) and during COVID (2021) outcomes by autism status. Next, we calculated the adjusted odds of each outcome among autistic children compared to those of children with and without other special healthcare needs at both time points. COVID-19 exacerbated autism-based disparities in food insecurity, SNAP, and public health insurance, but alleviated inequities in medical hardship, foregone work, and cash assistance. Autistic children did not experience declines in food insecurity or increases in SNAP like other children; medical hardship and foregone work decreased more for autistic children; and the magnitude of autism-based differences in public coverage significantly increased during the pandemic. Federal relief efforts likely improved economic outcomes of children; however, these effects varied according to type of hardship and by disability group. Efforts to promote economic well-being among autistic populations should be tailored to the financial challenges most salient to low-income autistic children, like food insecurity.

ADVANCING FOOD EQUITY AMONG OLDER ADULTS AND ADULTS WITH DISABILITIES IN THE US

Abstract Older adults and adults with disabilities face challenges related to food insecurity, defined as limited or uncertain access to adequate food due to economic and social conditions. Adults with disabilities have triple the risk of food insecurity than their peers and rates of food insecurity have been rising over the past two decades among older adults and food insecurity is known to be a risk factor for numerous adverse health outcomes. Despite knowledge of disparities, research is needed to identify and test strategies for addressing food insecurity disparities. This symposium will examine mechanisms that may contribute to food insecurity, including local food environments, vision impairment and access to the Supplemental Nutrition Assistance Program, which is the largest food assistance program in the U.S.. National data is used in all three studies to allow population-based inferences to be drawn from study findings. Results have potential to inform our understanding of food equity and advance data-driven policy and programmatic decisions.

Abstract B012: Prevalence of and disparities in food insecurity among racial/ethnic and sexual minority adults with cancers in the US: Analysis of the National Health Interview Survey

Abstract Background: In the US, food insecurity is a public health issue and can have a negative impact on the health and well-being of adult populations including those who have cancers. Data on food insecurity among lesbian, gay, bisexual, or other sexual minority (LGB+) adults with cancers (AWCs) is lacking. Further, disparities in food insecurity across LGB+ and racial/ethnic minority AWCs at the national level are not clear. Methods: We conducted a secondary analysis of publicly available data from the 2021 National Health Interview Survey that used stratified clustering sampling to interview US adults aged ≥18 years. We further limited the analysis to adults who 1) had a cancer diagnosis, 2) reported sex assigned at birth, and 3) self-identified as either straight/heterosexual or LGB+. Food insecurity, measured using a 10-item questionnaire assessing household food situations in the past 30 days, was dichotomized as “yes/no.” Weighted proportions and 95% confidence intervals (CI) were calculated and compared using Rao-Scott chi-square tests. Multivariable logistic regression was used to compute adjusted odds ratios (aOR [95% CI]) and examine differences in food insecurity by race/ethnicity and sexual orientation. All analyses accounted for complex survey design. Results: We obtained an unweighted sample of 3,517 (weighted sample 23,747,209) AWCs. The mean age was 65.4 years; 3.1% were self-identified as LGB+; 83.5% were White, 6.5% were Black, and 6.3% were Hispanic. Overall, 4.7% (95% CI: 3.8–5.6%) experienced food insecurity. LGB+ AWCs reported a higher proportion of having experienced food insecurity than heterosexual AWCs (14.7% [95% CI: 6.4–23.0%] vs. 4.4% [95% CI: 3.5–5.3%], p&amp;lt;.0001). Among female AWCs, LGB+ AWCs were more likely than heterosexual AWCs to have experienced food insecurity (20.1% [95% CI: 7.7–32.5%] vs. 5.2% [95% CI: 4.0–6.4%], p&amp;lt;.0001). Compared with White AWCs (3.8%, 95% CI: 2.9–4.7%), Black (10.0%, 95% CI: 5.1–15.0%) and Hispanic (9.7%, 95% CI: 5.4–14.1%) AWCs reported higher proportions of having experienced food insecurity (p&amp;lt;.0001). In the adjusted regression model, LGB+ AWCs had higher odds of food insecurity than heterosexual AWCs, though the difference was not statistically significant (aOR=2.01, 95% CI: 0.74–5.48). Black AWCs had higher odds of food insecurity than White AWCs (aOR=2.24, 95% CI: 1.15–4.36). AWCs on Medicaid/Medicare had greater odds of food insecurity than those privately insured (aOR=2.54, 95% CI: 1.43–4.52). AWCs who were not employed also had greater odds of food insecurity than those employed (aOR=3.56, 95% CI: 1.87–6.77). Conclusions: In this national sample of US AWCs, the prevalence of food insecurity was higher in LGB+ and racial/ethnic minority groups. Black and Hispanic AWCs were more likely than their White counterparts to have experienced food insecurity. Our findings suggest the need for intervention programs and public policies addressing food insecurity among AWCs, particularly among those who are in LGB+, racial/ethnic minority, or socioeconomically disadvantaged communities. Citation Format: Jincong Q. Freeman, Xinyi Li, Yong Gun Lee. Prevalence of and disparities in food insecurity among racial/ethnic and sexual minority adults with cancers in the US: Analysis of the National Health Interview Survey [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B012.

Disparities in food insecurity between sexual minority and heterosexual adults - a higher burden on bisexual individuals.

Sexual minorities-individuals who identify as gay/lesbian, bisexual, or other non-heterosexual individuals-experience higher rates of food insecurity (FI) compared to heterosexual individuals. During the COVID-19 pandemic, discrimination and structural racism, which are known risk factors for food insecurity, were perpetuated against sexual and racial/ethnic minorities. However, to our knowledge, a nationally representative analysis of the impact of the pandemic on food insecurity by sexual minority status and based on race/ethnicity is missing. We aimed to determine the degree of association between FI and sexual minority adults overall, before (2019) and during (2020-2021) the pandemic, and stratified by race/ethnicity. We used nationally representative data from the 2019-2021 National Health Interview Survey (NHIS). We specified multivariable logistic regression models to determine the association between FI and identifying as a sexual minority adult (≥18 years old), including gay/lesbian, bisexual, and other non-heterosexual individuals. Overall, we only observed FI disparities between bisexuals and heterosexuals (aOR 1.61 [95% CI 1.31-1.99]). Stratified by year, this association was significant only during the pandemic. Stratified by race/ethnicity, non-Hispanic white and non-Hispanic black individuals identifying as bisexual also experienced a significantly higher FI rate than their heterosexual counterparts. Our results may be a manifestation of the disproportionate impact of discrimination on bisexual individuals' FI experiences. With the growing number of legislative bills targeting the rights of sexual minorities, we expect to see a higher burden of FI among bisexuals, particularly, bisexual people of color. Future intersectional research regarding FI among bisexual and racial/ethnic minority individuals would further elucidate how membership in multiple minority groups may contribute to a higher risk of FI.

The impact of the 2021 Thrifty Food Plan benefit re-evaluation on SNAP participants' short-term food security and health outcomes.

The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program in the United States, and played a critical role in mitigating food insecurity during the COVID-19 pandemic. In 2021, the updated Thrifty Food Plan (TFP), which provides the basis of SNAP benefit allotments, led to a 21% monthly benefit increase for SNAP participants. The objective of this study was to examine the effects of the TFP re-evaluation on food insecurity, diet quality, and mental health using a natural experiment design. A longitudinal, web-based study was conducted among 1,004 United States adults with incomes at or below $65,000 in September 2021 (prior to the policy change) and February 2022 (after the policy change). Outcomes of interest included household food security, diet quality, perceived stress, and anxiety/depression, assessed using validated instruments. We used difference-in-differences regression modeling to assess the effects of the policy change on participants' outcomes, adjusting for sociodemographic covariates. Qualitative responses to open-ended questions about the policy change were analyzed using thematic analysis. Prior to the policy change, SNAP participants had significantly worse food insecurity, lower diet quality scores, and higher perceived stress and anxiety/depression when compared to non-participants (all Ps < 0.05). After adjustment for differences in sociodemographic characteristics, there were no significant effects of the TFP re-evaluation on food insecurity, diet quality, and mental health outcomes among SNAP participants relative to non-participants (all Ps > 0.05). Qualitative responses suggested that rising food prices and growing inflation potentially negated the benefits of the policy change; however, most SNAP participants described the added benefits as helpful in purchasing additional food supplies and offsetting other household costs during this period. The TFP benefit increase may have helped to prevent inflation-related disparities in food insecurity and health outcomes from widening among SNAP participants and non-participants. Further research is needed to determine the long-term impacts of this policy change.

Supplemental Nutrition Assistance Program Access and Racial Disparities in Food Insecurity

Racially minoritized people experience disproportionately high rates of food insecurity. The Supplemental Nutrition Assistance Program (SNAP) reduces food insecurity. To evaluate SNAP access with regard to racial disparities in food insecurity. This cross-sectional study used data from the 2018 Survey of Income and Program Participation (SIPP). On the basis of random sampling strategies, 44 870 households were eligible for the SIPP, and 26 215 (58.4%) participated. Sampling weights accounted for survey design and nonresponse. Data were analyzed from February 25 to December 12, 2022. This study examined disparities based on household racial composition (entirely Asian, entirely Black, entirely White, and multiple races or multirace based on SIPP categories). Food insecurity during the prior year was measured using the validated 6-item US Department of Agriculture Food Security Survey Module. SNAP participation during the prior year was classified based on whether anyone in the household received SNAP benefits. Modified Poisson regression tested hypothesized disparities in food insecurity. A total of 4974 households that were eligible for SNAP (income ≤130% of the poverty threshold) were included in this study. A total of 218 households (5%) were entirely Asian, 1014 (22%) were entirely Black, 3313 (65%) were entirely White, and 429 (8%) were multiracial or of other racial groups. Adjusting for household characteristics, households that were entirely Black (prevalence rate [PR], 1.18; 95% CI, 1.04-1.33) or multiracial (PR, 1.25; 95% CI, 1.06-1.46) were more likely to be food insecure than entirely White households, but associations differed depending on SNAP participation. Among households that did not participate in SNAP, those that were entirely Black (PR, 1.52; 97.5% CI, 1.20-1.93) or multiracial (PR, 1.42; 97.5% CI, 1.04-1.94) were more likely to be food insecure than White households; however, among SNAP participants, Black households were less likely than White households to be food insecure (PR, 0.84; 97.5% CI, 0.71-0.99). In this cross-sectional study, racial disparities in food insecurity were found among low-income households that do not participate in SNAP but not among those that do, suggesting that access to SNAP should be improved. These results also highlight the need to examine the structural and systemic racism in food systems and in access to food assistance that may contribute to disparities.

Food Insecurity Disparities Among Immigrants in the U.S.

Food insecurity negatively impacts public health and costs the U.S. healthcare system $53 billion annually. Immigrants are at higher risk of food insecurity. We sought to (1) characterize the prevalence of food insecurity among immigrants (i.e., noncitizens and naturalized citizens) and U.S.-born citizens and (2) determine whether Supplemental Nutrition Assistance Program utilization and income-poverty ratio levels impact the relationship between immigration status and food insecurity. Multivariable logistic regression models were used to determine the odds of food insecurity (dependent variables) using nationally representative data from the 2019-2020 National Health Interview Survey. Independent variables included immigration status, Supplemental Nutrition Assistance Program utilization, income-poverty ratio, and other important demographics. AORs with their 95% CIs are reported. Analysis was conducted in 2022. After controlling for independent variables, noncitizens had 1.28 (95% CI=1.02, 1.61) times higher odds of food insecurity than U.S.-born citizens. There was no food insecurity disparity between naturalized citizens and U.S.-born citizens. However, the association between immigration status and food insecurity varied significantly at different levels of Supplemental Nutrition Assistance Program utilization and income-poverty ratio. There were no food insecurity disparities between immigrants and U.S.-born citizens when they utilized the Supplemental Nutrition Assistance Program and when they had an income below 200% federal poverty level. Noncitizens who did not utilize the Supplemental Nutrition Assistance Program or those with an income above 200% federal poverty level were more likely to report food insecurity than their U.S.-born counterparts (AOR=1.32, 95% CI=1.01, 1.73 and AOR=1.88, 95% CI=1.24, 2.86, respectively). Moreover, naturalized citizens with an income above 200% federal poverty level were also more likely to report food insecurity than their U.S.-born counterparts (AOR=1.61, 95% CI=1.21, 2.14). Supplemental Nutrition Assistance Program utilization may likely eliminate food insecurity disparities among immigrants and U.S.-born citizens. However, among non-Supplemental Nutrition Assistance Program utilizers, significant food insecurity disparities remained between noncitizens and U.S.-born citizens after adjusting for independent variables. In addition, among individuals with incomes above 200% federal poverty level, significant food insecurity disparities were observed between immigrants and U.S.-born citizens. More research is needed to further understand the role that fear of deportation, ineligibility or lack of awareness about eligibility for the Supplemental Nutrition Assistance Program, and other factors such as structural racism play in food insecurity disparities between immigrants and U.S.-born citizens.

Food insecurity gaps in the Supplemental Nutrition Assistance Program based on disability status

BackgroundHouseholds including someone with disabilities experience disproportionately high food insecurity rates and likely face disproportionate barriers accessing Supplemental Nutrition Assistance Program (SNAP) benefits. ObjectiveThis article aims to examine the role of SNAP with regard to food insecurity disparities based on disability status. MethodsModified Poisson regression models examined food insecurity risk based on disability status (household includes no one with disabilities vs. those with work-limiting disabilities or non-work-limiting disabilities) among 2018 Survey of Income and Program Participation households eligible for SNAP (income ≤130% of the poverty threshold). Weighted estimates were used to account for the study design and non-response. ResultsHouseholds including someone with work-limiting disabilities were more than twice as likely to be food insecure than households including no one with disabilities (PR = 2.16, 95% CI: 1.90, 2.45); households including someone with non-work-limiting disabilities were 65% more likely (PR = 1.65, 95% CI: 1.39, 1.95). However, disparities were more pronounced among households not participating in SNAP (PR = 2.67, 95% CI: 2.22, 3.23 for work-limiting disabilities and PR = 1.86, 95% CI: 1.44, 2.40 for non-work-limiting disabilities) than SNAP-participating households (PR = 1.71, 95% CI: 1.45, 2.03 and PR = 1.46, 95% CI: 1.17, 1.82, respectively). Approximately 4.2 million low-income U.S. households including someone with disabilities are food insecure. Of these, 1.4 million were not participating in SNAP and another 2.8 million households were food insecure despite participating in SNAP. ConclusionsAccess to SNAP benefits is not proportionate to the scale of food insecurity among households that include people with disabilities. Action is needed to strengthen food assistance for those with disabilities.

An Analysis of Socioeconomic Determinants of the Black-White Disparity in Food Insecurity Rates in the US.

Previous research has not fully explored socioeconomic factors that influence the Black-White food insecurity disparities at the state and county levels in the United States. The goal of this study was to identify socioeconomic determinants associated with the Black-White food insecurity gap in the US at the state and county levels with rigorous quantitative investigation. The 2019 Map the Meal Gap dataset and multivariate regression analyses were used to identify factors associated with the prevalence of the Black-White disparity in food insecurity rates. Unemployment rate and median income gaps were found to be the strongest predictors of the Black-White disparity in food insecurity and the Black food insecurity rates in both state- and county-level models. Specifically, a 1% increase in Black unemployment rate compared with White unemployment rate was associated with a 0.918% and 0.232% increase in the Black-White disparity in food insecurity on average at the state and county levels, respectively. This study highlights the potential root causes of food insecurity and significant socioeconomic determinants associated with the Black-White food insecurity gap at the state and county levels in the US. Policymakers and program creators should implement action plans to address the income disparities and reduce unemployment rates among Blacks to eradicate this gap and ensure equity in food access between Blacks and Whites.

Food Insecurity Among Medicare Beneficiaries With Type 2 Diabetes: Implications for Diabetes Care and Education Specialists.

The purpose of the study was to examine factors associated with food insecurity among Medicare beneficiaries with type 2 diabetes. The 2019 Medicare Current Beneficiary Survey Public Use File of beneficiaries ≥65 years old with type 2 diabetes (n = 1343) was analyzed. A binary variable was created to represent food insecurity (1 = food insecurity, 0 = without food insecurity) with ≥2 affirmative responses adapting an established algorithm of the United States Department of Agriculture food insecurity questionnaire. A survey-weighted logistic model was performed to examine factors (ie, sociodemographic characteristics, health status, and insurance coverage) associated with food insecurity. Approximately 11.6% of study Medicare beneficiaries with type 2 diabetes reported food insecurity. Non-Hispanic Black beneficiaries were more likely to report food insecurity than non-Hispanic White beneficiaries. Beneficiaries with incomes < $25 000 were more likely to report food insecurity than those with higher incomes. Beneficiaries enrolled in Medicare Advantage programs (vs traditional Medicare), having Medicare-Medicaid dual eligibility (vs nondual), and living with instrumental activities of daily living or activities of daily living limitations (vs without) were also more likely to report food insecurity than their respective counterparts. Sociodemographic disparities in food insecurity were observed among Medicare beneficiaries with type 2 diabetes. Implementation of screening protocols, interventions related to social determinants of health, and the diabetes care continuum may mitigate the prevalence of food insecurity in this demographic.

Food insecurity disparities and impact on academic and social experiences among college students at a large public university

Objective: This research seeks to understand food insecurity experiences among students at a large public university in the southern United States. Participants: Participants consented and completed an online survey disseminated on campus in April–May 2021 (N = 418). The participants sampled were predominantly undergraduate (78.2%), females (72.4%), who lived off campus (54.1%), and were racially/ethnically diverse. Methods: Descriptive statistics, multivariable logistic regression, and chi-squared tests were used to examine the differences and association between demographic characteristics and behaviors and food insecurity status. Results: About 32% students surveyed had experienced food insecurity in the last year, which resembles national trends. There were significant differences in students’ food insecurity status by race, sexual orientation, first-generation status, residential category, and main mode of transportation. Food insecurity impacted academic and socioeconomic student behaviors. Conclusions: This research has implications for improving the academic, physical, and psychological wellbeing of university students and should inform future programs and policies.

INTERSECTIONALITY OF SENSORY LOSS AND RACE: IMPLICATIONS FOR BRAIN AND MENTAL HEALTH IN OLDER ADULTS

Abstract Despite recent evidence that sensory loss may increase risk of dementia, mood disorders, and poor physical health in older adults, nearly all research to-date has been conducted in populations that are predominantly White and from high-income countries. This session will investigate the intersectionality of race with sensory loss with a focus on health equity and inclusion of traditionally underrepresented populations. It will evaluate sensory loss across multiple senses, how patterns vary by race, and whether socioeconomic status can explain these differences. In the US, prevalence of impairment in vision, touch, and smell is lower in Whites compared to Black or Hispanics. Interestingly, hearing loss prevalence is lower in Blacks than Whites, but dementia incidence is higher. This session will describe incident dementia risk associated with hearing loss in Black compared to White Americans. It will also address the relationship between dual (hearing and vision) loss and depressive symptoms in India to explore the generalizability of findings to lower middle-income countries. Sensory impairments may intersect with racial discrimination to exacerbate social and health disparities. This session will also describe racial disparities in food insecurity among Americans with vision loss. Finally, we will present results of a randomized controlled trial of an innovative, community-delivered approach to affordable, accessible hearing care. The study represents the largest U.S.-based trial cohort to date of low-income older adults and older African American adults with hearing loss.

The determinants of food insecurity among developing countries: Are there any differences?

It has been widely recognized that certain socioeconomic factors play a crucial role in explaining food insecurity in a country or region. Yet, while the evidence continues to indicate substantial discrepancies in food insecurity across developing economies, no empirical study has attempted to determine the causes of these discrepancies. This study aimed to identify the leading causes of food insecurity in 107 developing countries spread across three separate continents between 2000 and 2019. The study employed recent techniques in data analysis that deal with heterogeneous panel methods robust to cross-sectional dependence. The panel-corrected standard error (PCSE) technique, which was used in the analysis, showed that disparities in food insecurity were not due to population growth, health services, or food production, since they had similar effects in all of the developing economies in Africa, Asia and the Latin America and the Caribbean region. However, political institutions, per capita income, and education were vital factors that explained the observed disparities in malnutrition between them.

Disparities in food insecurity among Black and White households: An analysis by age cohort, poverty, education, and home ownership

AbstractWe use the Current Population Survey's Food Security Supplement data to investigate food insecurity disparities among Black and White households across different age groups and socioeconomic characteristics. We find that disparities in the probability of food insecurity between Black and White households vary considerably across specific socioeconomic strata, in particular education, poverty status, and home ownership. Black households are systematically more food insecure than White, even when conditioning on other attributes, and even once household heterogeneity is eliminated. Thus, factors beyond socioeconomic characteristics may be more important in determining food insecurity disparities across Black and White households.

Disparities in food insecurity during the COVID-19 pandemic: A two-year analysis

While the overall level of food insecurity in the United States has remained stable during the COVID-19 pandemic, certain individuals and regions have fared worse than others. This study examines state-level variables affecting individual- and household-level food insecurity during the recent two years of the pandemic beginning in 2020 by utilizing the Household Pulse Survey, a new nationally representative dataset developed by the United States Census Bureau. The results of this study suggest a set of statewide factors, such as pandemic-driven market conditions, COVID-19 prevalence, and the implementation of federal programs, are associated with the level of food insecurity that individuals have experienced during the pandemic over the past two years. The associations varied by household income levels, indicating a strong relationship between higher-income households and market conditions, as well as the importance of federal programs and state policies in alleviating food insecurity among lower-income households. The food insecurity indices also overlapped with different socioeconomic and health hardships caused by the pandemic, such as employment income loss, housing instability, and mental health problems. The findings of this study highlight state-level contexts, particularly the role of state governments, in responding to pandemic-related food insecurity.

Prevalence and risk factors of food insecurity among Californians during the COVID-19 pandemic: Disparities by immigration status and ethnicity

The COVID-19 pandemic exacerbated socioeconomic disparities in food insecurity. Non-citizens, who do not qualify for most publicly-funded food assistance programs, may be most vulnerable to food insecurity during the pandemic. However, no study has examined heterogeneity in food insecurity by immigration status and ethnicity in the context of the pandemic. We analyzed the 2020 non-restricted California Health Interview Survey to examine disparities in food insecurity by ethnicity and immigration status (i.e., US-born, naturalized, non-citizen) among Asians and Latinxs (N = 19,514) compared to US-born Whites. Weighted multivariable logistic regression analyses assessed the association of immigration status and ethnicity with food insecurity. Decomposition analyses assessed the extent to which pandemic-related economic stressors, including experiencing reduced work hours or losing a job versus pre-pandemic socioeconomic position (SEP), accounted for disparities in food insecurity by ethnicity and immigration status. Regardless of immigration status, Latinxs were more likely to experience food insecurity than Whites. Based on the adjusted analyses, non-citizen, naturalized, and US-born Latinxs had a predicted probability of 12%, 11.4%, and 11.9% of experiencing food insecurity, respectively. In contrast, non-citizen Asians, but not US-born or naturalized Asians, reported greater food insecurity than Whites (12.5% vs. 8.2%). SEP accounted for 43% to 66% of the relationship between immigration status-ethnicity and food insecurity. The pandemic exacerbated economic hardship, but food insecurity was largely explained by long-standing SEP-related factors among Latinxs, regardless of immigration status, and non-citizen Asians. To address disparities in food insecurity, social assistance programs and COVID-19 economic relief should be extended to non-citizens.