Self-reported Food Insecurity Research Articles

Association of food insecurity with reduced cancer screening rates.

1592 Background: Social determinants of health, including access to adequate food and nutrition, influence many aspects of health, including cancer screening. This study explored the associations between food insecurity and cancer screening. Methods: A retrospective analysis was conducted using the National Health Interview Series from 2018-2022 to capture contemporary screening events. Based on scaled questionnaires, food security was stratified into either food secure or insecure, and then subgrouped into high, marginal, or low security. Associations were made with rates of undergoing at least one screening test. Relationships between variables were evaluated using Chi-Square and Cochran-Armitage trend tests. Logistic regression models were applied to find factors associated with cancer screening. Results: Patients included in analyses included: 51,957 for colon, 40,103 for breast, 45,983 for cervical, and 25,781 for prostate cancer screening. Between 2018-2022, those with food insecurity had significantly lower rates of cancer screening than those with food security across all four cancer screens, including colon (68.1% vs. 76.1%, p < 0.0001), cervical (83.3% vs. 87.5%, p < 0.0001), breast (73.3% vs. 79.5%, p < 0.0001) and prostate (41.3% vs. 54.0%, p < 0.0001) (Table). This was similar when comparing low, marginal, and high food security, respectively, for colon (68.1% vs. 68.2% vs. 76.1%, p < 0.0001), cervical (82.8% vs. 84.1% vs. 87.5%; p < 0.0001), breast (72.7% vs. 74.1% vs. 79.5%, p < 0.0001), and PSA screening (40.7% vs. 42.2% vs. 54.0%; p < 0.0001). Other variables were also analyzed, including insurance type, age, race, BMI, and health status. Those with public health insurance had lower screening rates for cervical cancer compared to those with private insurance (p < 0.0001). Individuals with food insecurity reported worse health than those who were food secure (p < 0.0001). Lower food security disproportionately affected Black patients (p < 0.001), and was associated with younger age (p < 0.0001) and higher rates of obesity (p < 0.0001). Conclusions: Individuals with self-reported food insecurity were found to have lower cancer screening rates than those who were food secure. Further analyses revealed associations between low food security status and obesity, public health insurance, younger age, and Black race. These data suggest that addressing food insecurity should be a priority, as these populations appear most vulnerable to lacking appropriate cancer screening. [Table: see text]

The Association Between Food Insecurity and Census Tract-Based Indexes in an Urban Academic Reproductive Clinic: Can Residence Predict Food Insecurity in Reproductive Patients? [ID 2683613

INTRODUCTION: Identifying food-insecure patients remains a priority in reproductive clinics given nutrition’s effect on maternal health. We sought to determine the association between self-reported food insecurity with census tract-based indexes including the Childhood Opportunity Index (COI), Social Vulnerability Index (SVI), and the U.S. Department of Agriculture (USDA) low-income and low-food access areas (LILAs), to identify which indexes can help identify at-risk patients. METHODS: This is a cross-sectional survey study (UMBHP-00099693) of patients presenting for reproductive care at one urban academic center. Food insecurity was scored as greater than 0 on the 6-Item USDA Food Security Module, and living within a LILA was collected from the 2019 USDA database. We categorized social vulnerability as moderate/low/very low vulnerability or high/very high vulnerability using the SVI. We categorized childhood opportunity using the COI as very low/low and moderate/high/very high. RESULTS: Of the 179 participants in the study, 84 (47%) reported food insecurity. The following proportions lived in a: LILA 96 (54%); high/very high vulnerability tract 138 (77%); and low/very low childhood opportunity (CO) tract 144 (86%). Living within a LILA was associated with an increased odds of experiencing food insecurity (odds ratio [OR] 1.8 [1.0, 3.4]). Living within a high/very high vulnerability tract was not significantly associated with food insecurity (OR 1.2 [0.6, 2.4]), nor was living within a low/very low CO tract (OR 1.6 [0.8, 3.5]). CONCLUSION: Residence within a LILA could be associated with food insecurity in patients seeking reproductive care, which can inform the development of future clinical and geographic interventions. As one in two patients were food insecure, we recommend universal screening of all patients at reproductive appointments.

Abstract P404: Food Insecurity Has a Moderation Effect in the Association Between Neighborhood Deprivation and Obesity Among Children

Background: Childhood obesity tracks into adulthood and is a risk factor for non-communicable diseases such as cardiovascular diseases and diabetes. The relationships between socioeconomic status (SES) (including food security, financial stability, and living conditions) and obesity among children have been well established. However, there is limited research on the heterogeneity of the role of food insecurity or insufficiency and neighborhood deprivation (ND) on obesity risk in children. We aimed to investigate the moderating effect of food insecurity in the association between ND, health insurance, race/ethnicity, and Body Mass Index (BMI) among children aged 3-11 years old. Methods: For this cross-sectional study of 223,653 children aged 3-11 years who were members of Kaiser Permanente in Southern California, weight and height were collected during routine annual medical visits and extracted from electronic health records. ND index (NDI) was based on patients’ addresses using 2021 regional data. Higher indices represent a higher deprivation. The risk of food insecurity was assessed using the Hunger Vital Sign™ tool on the well-child visit questionnaire. A multivariate linear regression analysis was performed with the absolute distance from the median BMI-for-age and sex based on the 2000 CDC growth charts. Models included age, sex, race/ethnicity, state-subsidized health insurance, self-reported risk food insecurity, and 2-way interaction terms for NDI and state-subsidized health insurance with food insecurity. Results: The cohort included children with a mean age of 7.9 years (SD 2.4), males (51.2%), Hispanics (50.3%), living with obesity (24.1%), resided in neighborhoods above the average deprivation (39.6%), and were enrolled in state-subsidized health insurance (25.6%). The risk of food insecurity and insufficiency were reported at 5.0% and 3.3%, respectively. In adjusted models, a higher NDI quintile, state-subsidized health insurance, race/ethnicity, and food insecurity were all associated with a higher BMI (p<0.0001). Food insecurity also moderated the association between NDI and BMI (p = 0.0244) and between state-subsidized health insurance and BMI (p = 0.0034). The effect of food insecurity was highest among those with the least ND and with private health insurance. In a separate model, food insecurity had no moderating effect in the association between race/ethnicity and BMI (p = 0.1). Conclusion: Food insecurity showed a moderating effect on high BMI risk among children in higher deprived neighborhoods and enrolled in state-subsidized health insurance. This study highlights the possible effects of food insecurity on obesity among children regardless of race/ethnicity. Future studies are recommended to investigate the moderating role of food insecurity in health outcomes, specifically obesity-associated conditions among children with low SES.

Predicting food insecurity among UK university students during the COVID-19 pandemic.

The present study investigated potential predictors of food insecurity among UK university students during the COVID-19 pandemic. Close-ended questionnaire administered to a cross-sectional sample of UK university students. Data were collected using an online survey platform in October 2020, during the COVID-19 pandemic. A nationally representative sample of UK university students (n 640). Odds ratios (OR) obtained from logistic regression were statistically significant for three measures of economic hardship. First, students who relied on financial aid from student loans were 1·9 times more likely to report being food insecure than students who did not rely on financial aid from student loans. Second, students who could not pay their utility bill (v. those that could pay) were 3·1 times the odds of being food insecure. Finally, as perceived difficulty in paying for accommodation increased across the sample, the odds of being food insecure also increased (OR = 1·9). We also found that students who were recently ill were 2·2 times more likely to be food insecure compared with students who were not recently ill. We did not find any evidence that testing positive for COVID-19 predicted food insecurity, and university supplied food parcels/boxes did not reduce student food insecurity. Both economic factors and illness play a significant role in self-reported food insecurity in higher education students during pandemic lockdown. Further research is needed to explore food insecurity, economic factors and illness outside of a pandemic context.

FOOD INSECURITY AMONG OLDER ADULTS IN THE UNITED STATES DURING THE COVID-19 PANDEMIC

Abstract The COVID-19 pandemic severely impacted food access and nutritional security across the United States, and exacerbated disparities in household food insecurity rates particularly among older adults due to potential for reduced food access, mental or physical health limitations, or fixed incomes. This study investigated food insecurity among older adults in the US throughout time periods of the pandemic, exploring differences among population groups for food insecurity risk factors. Data was from the US Census Bureau’s Household Pulse Survey, April 2020 through December 2022, weight-adjusted for a nationally representative sample (n=3,884,922). Logistic regression models were constructed to examine the association between older age and self-reported household food insecurity. Reasons given for food insecurity were examined as secondary outcomes. Covariates included demographics, socioeconomic status, household structure, food support programs, and mental health status. Findings showed risk of food insecurity among adults aged 60+ years more than doubled among minority racial groups compared to non-Hispanic White (p<0.001) but was inversely associated with being female compared to male (OR 0.77, p<0.001). Older adults who reported experiencing at least one mental health indicator (anxiety, depression, low interest, or worry) more than half of the week had over five times the odds of being food insecure (OR 5.68, p<0.001). Overall, trends and factors associated with prevalence and reasons for food insecurity were found to vary across age groups, and at different points of the pandemic. Our findings can help elucidate factors to identify older adult groups at greater food insecurity risk.

Food insecurity, COVID-19 and diets in Fiji – a cross-sectional survey of over 500 adults

IntroductionFood insecurity is associated with inadequate nutrition and increased rates of chronic disease. The primary aim of this study was to assess self-reported food insecurity and the perceived impact of COVID-19 on food security, in two regional districts of Central Fiji, as part of a broader program of work on strengthening and monitoring food policy interventions. The secondary aim was to explore the relationship between food insecurity and salt, sugar and fruit and vegetable intake.MethodsSeven hundred adults were randomly sampled from the Deuba and Waidamudamu districts of Viti Levu, Fiji. Interview administered surveys were conducted by trained research assistants with data collected electronically. Information was collected on demographics and health status, food security, the perceived impact of COVID-19 on food security, and dietary intake. Food insecurity was assessed using nine questions adapted from Fiji’s 2014/5 national nutrition survey, measuring markers of food insecurity over the last 12 months. Additional questions were added to assess the perceived effect of COVID-19 on responses. To address the secondary aim, interview administered 24-hour diet recalls were conducted using Intake24 (a computerised dietary recall system) allowing the calculation of salt, sugar and fruit and vegetable intakes for each person. Weighted linear regression models were used to determine the relationship between food insecurity and salt, sugar and fruit and vegetable intake.Results534 people participated in the survey (response rate 76%, 50.4% female, mean age 42 years). 75% (75.3%, 95% CI, 71.4 to 78.8%) of people reported experiencing food insecurity in the 12 months prior to the survey. Around one fifth of people reported running out of foods (16.8%, 13.9 to 20.2%), having to skip meals (19.3%, 16.2 to 22.9%), limiting variety of foods (19.0%, 15.9 to 22.5%), or feeling stressed due to lack of ability to meet food needs (19.5%, 16.4 to 23.0%). 67% (66.9%, 62.9 to 70.7%) reported becoming more food insecure and changing what they ate due to COVID-19. However, people also reported positive changes such as making a home garden (67.8%, 63.7 to 71.6%), growing fruit and vegetables (59.5%, 55.6 to 63.8%), or trying to eat healthier (14.7%, 12.0 to 18.0%). There were no significant associations between food insecurity and intakes of salt, sugar or fruit and vegetables.ConclusionParticipants reported high levels of food insecurity, exceeding recommendations for salt and sugar intake and not meeting fruit and vegetable recommendations, and becoming more food insecure due to COVID-19. Most participants reported making home gardens and/or growing fruit and vegetables in response to the pandemic. There is an opportunity for these activities to be fostered in addressing food insecurity in Fiji, with likely relevance to the Pacific region and other Small Island Developing States who face similar food insecurity challenges.

Food Insecurity, Race and Ethnicity, and Cognitive Function Among United States Older Adults

BackgroundCognitive impairment and dementia are severe public health issues in aging populations, which can be exacerbated by insufficient or unhealthy dietary intake. Food (in)security status is linked to cognitive function among older adults, but the relationship is complex and can vary by sociodemographic characteristics. ObjectiveThis article aimed to investigate the association between food insecurity and cognitive function among United States older adults and explore potential variations by race and ethnicity groups. MethodsWe prospectively examined changes in cognitive function and incidence of cognitive impairment alongside the presence of self-reported food insecurity among older adults of different racial and ethnic groups. Data were from the 2012–2018 Health and Retirement Study (HRS) and the 2013 Health Care and Nutrition Study (HCNS), including N = 6,638 United States adults aged 50 years and older. Food insecurity was measured by a self-reported United States Household Food Security Survey Module, and cognitive function was assessed by the modified version of the Telephone Interview for Cognitive Status. ResultsResults showed that 17% of United States older adults reported food insecurity in the 2013 HCNS. Compared with food secure older adults, those reporting food insecurity experienced worsened cognitive functioning over time (B = −0.63, p < .001), and they were more likely to have onset of cognitive impairment (OR= 1.46, p < .001) in the 6-y observation. Compared with non-Hispanic White older adults, being non-Hispanic Black, non-Hispanic Other, or Hispanic was associated with 2.96, 2.09, or 1.26 odds (p < .001) of cognitive impairment (2012–2018), respectively. Older adults of racial and ethnic minority groups also had higher risks of experiencing the double burden of cognitive impairment alongside food insecurity compared with non-Hispanic White older adults. ConclusionFindings underscore racial and ethnic structural disparities in food security and cognitive health in the United States aging population.

COVID-19-Associated Food Insecurity and Mental Health Symptoms Among Latinx Adults in the United States.

Introduction: U.S. Latinx adults were disproportionately burdened by COVID-19 infection, as well as food insecurity compared to their non- Hispanic white adults. It is less clear if within-group variations among U.S. Latinx adults exist in food insecurity and mental health outcomes. Methods: We conducted a secondary data analysis of repeated cross-sectional survey waves from the Understanding America Study (UAS) study (N = 182,865). We computed multivariable generalized linear regression models to examine associations between food insecurity, demographic characteristics, and depressive symptoms. Results: Participants with a history of food insecurity had a higher prevalence of depressive symptoms compared to those without a history of food insecurity (21.1% compared to 5.23%, p < .0001). Mexican participants reported a significantly higher prevalence of depression compared to Latino participants of Puerto Rican, Central American, or another Latino ethnicity (8.94% compared to 2.84%, 1.76%, and 2.91%, respectively, p < .0001). Associations of self-reported food insecurity among men and women varied by asthma status. Conclusions: Our study demonstrates that participants with a history of food insecurity had a higher prevalence of depressive symptoms compared to those without a history of food insecurity. Our findings also illuminate the importance of disaggregating U.S. Latinx adults when examining associations between food insecurity and mental health.

Impact of food-related conflicts on self-reported food insecurity

Food security is recognized as an inherent human right, enshrined within the principles of the Agenda 2030. The Global Report of Food Crises 2022 points out 193 million people facing severe food insecurity across 53 countries, posing challenges to decision-makers and institutions. Among the many causes of food crises, violent conflict, economic shocks, and environmental pressures are the most influential. In this work, we focus primarily on the conflict-related domain. Finding a stable relationship between conflict and food insecurity is complex for several reasons: first, the relationship is mutually reinforcing; second, the full impact of conflict on food insecurity may take time to have an effect; and third, conflict itself is a multidimensional phenomenon and can include multiple types of violent events. This research set out to comparatively assess the impact of different types of violence on self-reported food insecurity in three prominent food crisis contexts: Burkina Faso, Syria, and Yemen. A measure of food-related classifying events was developed using a rules-based approach. The analysis showed that this approach can effectively code and classify food-related conflict in diverse contexts. By refining the search string, it becomes possible to capture food-related conflict in various food systems. Our findings point out that the new-build measure of food-related conflict is more strongly correlated to subsequent self-reported insufficient food consumption than other forms of violence. The results demonstrate that this relationship is robust across a range of data collection windows and across discrete time periods of analysis. In summary, the research suggests that focusing on the use of food and food systems as tactics in conflict can be highly valuable for understanding and addressing food insecurity.

Contributions of Trauma and Economic Insecurity to Psychological Distress in Response to the COVID-19 Pandemic.

Racially minoritized women with limited socioeconomic resources are at increased risk for adverse psychological outcomes in response to the COVID-19 pandemic. Disproportionate rates of trauma exposure and economic insecurity likely heighten risk for these outcomes among socioeconomically vulnerable individuals, but the unique contributions of these factors are poorly understood. As such, we examined trauma and economic factors as predictors of pandemic-related psychological distress and symptoms. Ninety-six women recruited for a trauma research study (91.7% Black, Mage=38.3 years, SDage=11.8 years) completed measures of trauma exposure, economic insecurity, and several items assessing psychological distress and symptoms related to the COVID-19 pandemic. We examined concern for mental and physical health impacts of COVID-19 as well as changes in self-reported levels of anxiety and anhedonia from the three months prior to the pandemic to the past two weeks. Linear regression analyses were used to assess contributions of trauma exposure and economic insecurity to COVID-19-related distress. Childhood maltreatment and lifetime trauma exposure did not predict COVID-19-related distress; however, financial concern significantly contributed to concern for the physical health impact of COVID-19 (B = .30, p < .05). Food insecurity emerged as the only significant predictor of concern for mental health impact of COVID-19 (B=.91, p < .01). Housing instability was the only significant predictor of COVID-19-related increases in anhedonia (B = -.30, p < .05). Economic insecurity, namely self-reported financial concern, food insecurity, and housing instability, was related to COVID-19-related psychological distress in a sample of predominately Black American women living in under-resourced communities. Findings may help identify populations at risk for COVID-19-related psychological distress and symptoms and develop effective interventions, such as expanding access to nutritious food sources and housing support, for minoritized community members.

Spatial characteristics of food insecurity and food access in Los Angeles County during the COVID-19 pandemic

Food insecurity spiked in some U.S. regions during the COVID-19 pandemic, as did food access challenges. Concerns were raised that these food issues were more prominent in food deserts, or neighborhoods lacking access to a grocery store or supermarket. Using data collected from a representative sample of Los Angeles County adults between April and October 2020, this study examined relationships between self-reported food insecurity, perceived food access barriers, and residing in a food desert, and examined differences across key geographic regions of the county. There was little relationship between residing in a food desert and experiencing food insecurity. However, perceived grocery store closures/limited hours and not having access to a vehicle were commonly reported barriers to food access, which were associated with more food insecurity. These findings suggest that geographic disparities in food access impact food insecurity. Efforts to address food insecurity should center on achieving food justice and addressing disparities across geographic regions.

Food insecurity during the COVID-19 pandemic who use drugs in Vancouver, Canada.

To examine prevalence and factors associated with food insecurity among people who use drugs (PWUD) during the first year of the COVID-19 pandemic and the overdose crisis. This cross-sectional study employs multivariable logistic regression to identify factors associated with self-reported food insecurity. PWUD who are part of three community-recruited cohorts. Interviews conducted in Vancouver, Canada, via phone between July and November 2020 in adherence to COVID-19 safety procedures. Among 765 participants, including 433 (56·6 %) men, eligible for this study, 146 (19·1 %; 95 % CI: 16·3 %, 21·9 %) reported food insecurity in the past month. Of the participants reporting food insecurity, 114 (78·1 %) reported that their hunger levels had increased since the beginning of the pandemic. In multivariable analyses, factors independently and positively associated with food insecurity included: difficulty accessing health or social services (adjusted OR (AOR) = 2·59; 95 % CI: 1·60, 4·17); having mobility difficulties (AOR = 1·59; 95 % CI: 1·02, 2·45) and engaging in street-based income generation (e.g. panhandling and informal recycling) (AOR = 2·31; 95 % CI: 1·45, 3·65). Approximately one in five PWUD reported food insecurity during this time. PWUD with mobility issues, who experienced difficulty accessing services and/or those engaged in precarious street-based income generation were more likely to report food insecurity. Food security is paramount to the success of interventions to prevent COVID-19 and drug toxicity deaths. These findings suggest a need for a more unified state response to food insecurity that prioritises and incorporates accessibility and autonomy of the communities they serve.

Association of food insecurity with reduced cancer screening rates.

e18609 Background: Social determinants of health, including access to adequate food and nutrition, may influence many aspects of healthcare, including cancer screening. This study explored the associations between food insecurity and cancer screening. Methods: A retrospective analysis was conducted using the National Health Interview Series from 2021 to capture contemporary events. Based on scaled questionnaires, food security was stratified into either food secure or insecure, and then subgrouped into high, marginal, or low security (i.e. most insecure). Associations were made with rates of having at least one screening test. Relationships between variables were evaluated using Chi-Square and Cochran-Armitage trend tests. Logistic regression models were used to find factors associated with cancer screening. Results: Patients included in analyses included: 19,916 for colon, 15,293 for cervical, and 8,589 for prostate cancer screening. Those with food insecurity had significantly lower rates of cancer screening than those with food security across all 3 cancer screens, including for colon (51.3% vs. 61.8% p &lt; 0.0001), cervical (78.1% vs. 85.2% p &lt; 0.0001), and prostate (36.0% vs. 51.5%, p &lt; 0.0001). This was similar when comparing low, marginal, and high food security, respectively, for colonoscopies (50.1% vs. 52.6% vs. 61.8%, p &lt; 0.0001), cervical cancer screening (78% vs. 78.2% vs. 85.1%; p &lt; 0.0001), and prostate-specific antigen testing (31.2% vs. 41.2% vs. 51.5%; p &lt; 0.0001). Other social determinants were analyzed, including insurance type (public vs. private), age, and race. Patients with public health insurance had lower screening rates across all three cancers compared to those with private insurance (p &lt; 0.0001). Lower food security was linked with younger age (p &lt; 0.0001), and Black patients were disproportionately affected by food insecurity compared to other races (p &lt; 0.001). Adjusted for covariates, low food security, minority racial groups, and public insurance were associated with lower odds of cancer screening. Conclusions: Individuals with self-reported food insecurity were found to have lower cancer screening rates than those who were food secure. Further analysis of demographic and clinical information revealed associations between low food security status and public health insurance, younger age, and Black race. These data suggested that measures can be taken to address food insecurity in these populations that appear to be most vulnerable to lacking appropriate cancer screening. [Table: see text]

Telehealth During COVID-19 for Adults with Multiple Chronic Conditions: Associations with Self-Reported Food Insecurity and with Physical Limitations.

Background: Adults with chronic medical conditions complicated by food insecurity or physical limitations may have higher barriers to accessing telehealth implemented during the COVID-19 pandemic. Objective: To examine the relationships of self-reported food insecurity and physical limitations with changes in health care utilization and medication adherence comparing the year before (March 2019-February 2020) and the first year of the COVID-19 pandemic (April 2020-March 2021) among patients with chronic conditions insured by Medicaid or Medicare Advantage. Methods: A prospective cohort study of 10,452 Kaiser Permanente Northern California members insured by Medicaid and 52,890 Kaiser Permanente Colorado members insured by Medicare Advantage was conducted. Difference-in-differences (DID) between the pre-COVID and COVID years in telehealth versus in-person health care utilization and adherence to chronic disease medicines by food insecurity and by physical limitation status were measured. Results: Food insecurity and physical limitations were each associated with small but significantly greater shifts from in-person to telehealth. Medicare Advantage members with physical limitations also had significantly greater decline in adherence to chronic medications from year to year compared with those without physical limitations (DID from pre-COVID year to COVID year ranged from 0.7% to 3.6% greater decline by medication class, p < 0.01). Conclusions: Food insecurity and physical limitations did not present significant barriers to the transition to telehealth during the COVID pandemic. The greater decrease in medication adherence among older patients with physical limitations suggests that care systems must further address the needs of this high-risk population.

Food Security is Associated with Higher Diet Quality Among Children of the US–Affiliated Pacific Region

BackgroundThe prevalence of food insecurity and its relationship to diet quality are factors impacting the health of persons living across the United States–affiliated Pacific region (USAP). ObjectivesThe aim of this study was to describe characterize the relationship between household food security status and diet quality of 2- to 8-y-old children across jurisdictions in the USAP. MethodsBaseline data from 2- to 8-y-olds (n = 3099) enrolled in the Children’s Healthy Living Program for Remote Underserved Minority Populations in the Pacific region, an obesity prevention study conducted in communities across Alaska, American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, and Hawaii, and a concomitant prevalence study in communities across the Freely Associated States (FAS) (the Federated States of Micronesia: Kosrae, Pohnpei, Chuuk, Yap; Republic of Marshall Islands; Republic of Palau) were collected in 2012. Caregivers self-reported sociodemographic data and food insecurity. Assisted by their caregiver, children completed two dietary records on nonconsecutive, randomly assigned days. The Healthy Eating Index 2005 (HEI-2005) was used to assess the diet quality. Data were summarized overall and by jurisdiction. Differences in HEI-2005 and HEI component scores among jurisdictions and by household food security status were tested using 1-factor ANOVA. ResultsHalf or more of participants from American Samoa, Guam, CNMI, and FAS reported household food insecurity (n = 295, 59.7%; n = 292, 49.9%; n = 267, 54.6%; n = 572, 69.0%, respectively). HEI-2005 scores varied by jurisdiction (P < 0.001) and were significantly lower among FAS participants (54.7 ± 1.2) than among all other jurisdictions (P < 0.05). Total diet quality scores did not differ by food security status (59.9 ± 0.8 food secure compared with 58.3 ± 1.1 food insecure, P = 0.07); however, most diet quality adequacy component scores were significantly higher and moderation component scores significantly lower among participants in food secure households than those in food insecure households. ConclusionsSignificant differences in children’s diet quality and household food security existed across USAP jurisdictions.

Intersectionality of Self-Reported Food Insecurity and Perceived Stress of College Students at a Land-Grant Southeastern Higher Education Institution during the COVID-19 Pandemic

College food insecurity (FI) and poor psychosocial health are prevalent public health issues in the U.S., yet often overlooked. Since the COVID-19 pandemic, repercussions on these critical inequity issues remain unclear. During the summer months of 2020, this cross-sectional survey examined associations between students’ self-reported FI and perceived stress (PSS-10), one aspect of poor psychosocial health. An anonymous online survey was distributed to a convenience sample of college students at a land grant institution of higher education in the southeastern U.S., and $10 e-gift card was provided to survey respondents. The survey response rate was 26.2% (n=235) and participants were predominantly female, White, and from upper-division including junior and senior students. Among respondents, 31.3% were food insecure and 37.8% were laid off or temporarily furloughed. Students who worked before the pandemic were 3.49 times more likely to continue working despite the pandemic; however, employment status was not significantly associated with since-PSS-10 scores or FI. In multiple linear regression models, pre-PSS-10 scores, age, and lower division were significant predictors of since-PSS-10 scores. Additionally, students experiencing FI and having higher pre-PSS-10 scores were predicted of having higher since-PSS-10 scores. This study adds important findings about college FI and perceived stress to the limited literature regarding college student health during the pandemic. A more rigorous study design with a larger, nationally or regionally representative sample is recommended for future studies. To address both complex issues of college FI and poor psychosocial health, a multi-faceted interdisciplinary approach, well-supported by college administrators, would be warranted.

Household Food Insecurity, Anemia, Malnutrition and Unfavorable Dietary Diversity among Adolescents: Quadruple Whammies in the Era of Escalating Crises in Lebanon.

Adolescence is a transitional period between childhood and adulthood. Nowadays, adolescents in Lebanon are growing during a time of unprecedented health crises and political instability. This study aimed to determine the prevalence and correlates of malnutrition, dietary diversity in adolescents' households, and adolescents' self-reported food insecurity in Lebanon. A national representative sample of 450 parent-adolescent dyads (parents: mean age ± standard deviation (SD) = 46.0 ± 7.0, mothers: 59.0%; adolescents: mean age ± SD = 15.0 ± 3.0, girls: 54.6%) were interviewed. Anthropometric and blood hemoglobin measurements were performed for adolescents. The Food Consumption Score, the Arab Family Food Security Scale and the Adolescent-Level Food-Security Scale were used. The overall prevalence of adolescent stunting, thinness, overweight, obesity and anemia was 6.7%, 4.7%, 19.3%, 12.9% and 16.7%, respectively. Almost 40.4% and 68% of adolescent's households consumed undiversified diets and were food insecure, respectively. Food insecurity (FI) affected 54.0% of adolescents. Adolescents attending schools (vs. university) were eight times more likely to be stunted (p = 0.04). Boys had a 4.3 times higher thinness risk (p = 0.005) compared to girls. Households reporting an income decline since the start of the Lebanese economic crisis were three times more likely to have a thin adolescent (p = 0.01). Parental overweight/obesity (p = 0.002) and lower education level (p = 0.04) nearly doubled the risk of adolescent overweight or obesity. At a time when escalating crises in Lebanon are shifting diets for the youngest generations, the development of adolescent-responsive nutritional policies becomes a must.

Self-Reported Vision Impairment and Food Insecurity in the US: National Health Interview Survey, 2011–2018

ABSTRACT Purpose To determine if vision impairment (VI) is associated with food insecurity among the United States (US) adults. Methods This is a cross-sectional study of US adults ≥18 years below a threshold of 150% poverty from the National Health Interview Survey (NHIS), years 2011–2018. Outcome measures included food insecurity status, based on response to the NHIS adult (10-item) food insecurity tool, either as a binary (food secure or insecure) or ordinal (high, marginal, low, and very low) variable. VI was defined as self-reported trouble seeing, even when wearing glasses or contact lenses. Multivariable logistic regression analyses adjusted for potential confounders examined associations between VI and food insecurity. Results Participants (N = 62075) were majority female (57%), White (62%), and non-Hispanic (74%). Of them, 16% reported VI and 28% were food insecure. In fully adjusted logistic regression models, adults with VI had 216% higher odds (95% CI = 2.01–2.31) of being food insecure than adults without VI. Further, there was a dose–response relationship between VI and food insecurity noted in a multinomial model: VI predicted 159% higher risk of marginal food security (95% CI = 1.44–1.75), 197% higher risk of low food security (95% CI = 1.80–2.16), and 295% higher risk of very low food security (95% CI = 2.69–3.22), as compared to high food security. Conclusion VI is associated with food insecurity, increasingly so among adults with highest levels of food insecurity in this national sample of low-income US adults. This data highlights the need for targeted interventions to address and reduce the burden of food insecurity among US adults with VI.

Mental health assessment of youth with sickle cell disease and their primary caregivers during the COVID-19 pandemic.

Youth with sickle cell disease (SCD) and their caregivers are susceptible to stress and depression, perhaps exacerbated by pandemic‐associated health and economic concerns. Most of the 50 youth–caregiver dyads enrolled in the multisite trial, Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT), took an online survey of self‐reported mental health symptoms and food insecurity during the 2020 COVID‐19 pandemic. Compared to largely pre‐pandemic results, prevalence of mental health symptoms in dyad members appeared to have shifted: fewer youth and more caregivers were affected during the pandemic; many of both groups lacked optimism. Pandemic/post‐pandemic screening of youth with SCD for mental health symptoms and food insecurity appears warranted.

Food insecurity and associated depression among older adults in India: evidence from a population-based study

ObjectiveThe present study aimed to examine the associations of several indicators of food insecurity with depression among older adults in India.DesignA cross-sectional study was conducted using country-representative survey data.Setting and...