The Burden of Food Insecurity on Quality of Life in Adults with Diabetes
Abstract
:1. Introduction
2. Methods
2.1. Sample
2.2. Outcome—Quality of Life
2.3. Food Insecurity
- “How often in the last 30 days has anyone in the household worried whether food would run out before getting money to buy more?” Score of 1 if the participant responded ‘often’ or ‘sometimes’.
- “How often in the last 30 days did the food purchased not last and the person/household didn’t have money to get more?” Score of 1 if the participant responded ‘often’ or ‘sometimes’
- “How often in the last 30 days could the person/household not afford to eat balanced meals?” Score of 1 if the participant responded ‘often’ or ‘sometimes’.
- “In the last 30 days, did the person/household reduce or skip meals because there wasn’t enough money for food?” Score of 1 if the participant responded ‘yes’.
- “How many meals were skipped in the last 30 days?” Score of 1 if the participant responded with 3+ days.
- “In the last 30 days, did the person/household ever eat less because there wasn’t enough money for food?” Score of 1 if the participant responded ‘yes’.
- “In the last 30 days, was the person/household ever hungry but didn’t eat because there wasn’t enough money for food?” Score of 1 if the participant responded ‘yes’.
- “In the last 30 days, did anyone in the household lose weight because there wasn’t enough money for food?” Score of 1 if the participant responded ‘yes’.
- “In the last 30 days, did anyone in the household not eat for a whole day because there wasn’t enough money for food?” Score of 1 if the participant responded ‘yes’.
- “How many days in the last 30 days did anyone in the household not eat for a whole day because there wasn’t enough money for food?” Score of 1 if the participant responded with 3+ days.
2.4. Covariates
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total | Food Secure | Food Insecure | p-Value | |
---|---|---|---|---|
Age | <0.001 | |||
18–44 | 10.1% | 9.1% | 16.9% | |
45–64 | 44.4% | 42.6% | 55.8% | |
65+ | 45.5% | 48.3% | 27.3% | |
Gender | <0.001 | |||
Male | 51.1% | 53.5% | 35.7% | |
Female | 48.9% | 46.5% | 64.3% | |
Education | <0.001 | |||
Less than High School Diploma | 17.0% | 15.9% | 24.0% | |
High School Diploma/GED | 33.2% | 33.0% | 34.3% | |
College | 49.8% | 51.1% | 41.6% | |
Race/Ethnicity | <0.001 | |||
Non-Hispanic White | 61.3% | 63.1% | 50.2% | |
Non-Hispanic Black | 16.9% | 15.8% | 23.9% | |
Hispanic | 14.3% | 13.6% | 18.8% | |
Other | 7.5% | 7.5% | 7.0% | |
Marital Status | <0.001 | |||
Married | 46.0% | 48.7% | 29.3% | |
Widowed/Divorced/Separated | 41.0% | 39.7% | 49.5% | |
Never Married | 12.9% | 11.6% | 21.2% | |
Region | 0.15 | |||
Northeast | 16.2% | 16.4% | 15.4% | |
West | 20.3% | 20.9% | 16.1% | |
South | 42.1% | 41.2% | 48.0% | |
Midwest | 21.4% | 21.5% | 20.5% | |
Poverty | <0.001 | |||
Poor/Near Negative | 16.7% | 13.7% | 35.5% | |
Near Poor | 6.9% | 5.8% | 13.8% | |
Low Income | 16.9% | 15.9% | 23.4% | |
Middle Income | 26.9% | 27.8% | 21.1% | |
High Income | 32.7% | 36.8% | 6.2% | |
Insurance | <0.001 | |||
Private | 58.9% | 62.9% | 32.8% | |
Public | 37.2% | 33.6% | 59.9% | |
Uninsured | 4.0% | 3.4% | 7.3% | |
Employment | <0.001 | |||
Employed | 39.1% | 40.9% | 27.0% | |
Unemployed | 60.9% | 59.1% | 73.0% | |
Stroke | 11.4% | 11.1% | 13.6% | 0.16 |
High Blood Pressure | 78.3% | 78.6% | 76.2% | 0.40 |
Emphysema | 5.6% | 4.8% | 11.2% | <0.001 |
Chronic Pain | 58.8% | 57.8% | 65.5% | 0.01 |
Arthritis | 54.0% | 53.4% | 58.1% | 0.13 |
Asthma | 15.1% | 13.2% | 27.3% | <0.001 |
High Cholesterol | 75.8% | 76.2% | 73.4% | 0.30 |
Coronary Heart Disease | 15.9% | 16.2% | 14.0% | 0.30 |
Angina | 6.9% | 6.8% | 7.8% | 0.55 |
Heart Attack | 13.3% | 12.9% | 16.1% | 0.10 |
Heart Disease | 22.3% | 22.0% | 24.2% | 0.36 |
Other Heart Disease | 23.3% | 22.8% | 26.1% | 0.19 |
Bronchitis | 4.6% | 3.9% | 9.2% | <0.001 |
Cancer | 20.3% | 21.0% | 15.3% | 0.01 |
Physical Health Component (PCS) | Mental Health Component (MCS) | |
---|---|---|
Food Secure | 42.2 (41.6, 42.8) | 51.5 (51.0, 51.9) |
Food Insecure | 35.9 (34.5, 37.3) | 42.3 (41.5, 43.9) |
Unadjusted | Adjusted | |
---|---|---|
Estimate (95% CI) | Estimate (95% CI) | |
Food Security Status | ||
Food Secure (ref) | - | - |
Food Insecure | −6.31(−4.83, −7.80) *** | −3.44 (−2.25, −4.63) *** |
Age | ||
18–44 (ref) | - | |
45–64 | −1.54 (−3.12, 0.04) | |
65+ | −0.28 (−2.07, 1.51) | |
Gender | ||
Male (ref) | - | |
Female | −0.59 (−1.70, 0.51) | |
Education | ||
<High School (ref) | - | |
High School Diploma/GED | 0.55 (−0.80, 1.89) | |
College | 0.54 (−0.75, 1.84) | |
Race/Ethnicity | ||
Non-Hispanic White (ref) | - | |
Non-Hispanic Black | −0.76 (−1.79, 0.27) | |
Hispanic | 0.07 (−1.40, 1.54) | |
Other | 0.01 (−1.67, 1.70) | |
Marital Status | ||
Married (ref) | - | |
Widow/Divorce/Separated | −0.08 (−1.24, 1.08) | |
Never Married | 0.21 (−1.36, 1.78) | |
Region | ||
Northeast (ref) | - | |
West | −1.76 (−0.03, −3.49) * | |
South | −1.61 (−0.23, −2.99) * | |
Midwest | −1.79 (−0.31, −3.27) * | |
Poverty | ||
Poor/Near Negative (ref) | - | |
Near Poor | −0.50 (−2.21, 1.20) | |
Low Income | 0.22 (−1.19, 1.62) | |
Middle Income | 1.81 (0.39, 3.24) * | |
High Income | 3.36 (1.74, 4.98) *** | |
Insurance | ||
Private (ref) | - | |
Public | −0.91 (−2.10, 0.29) | |
Uninsured | 1.22 (−0.57, 3.02) | |
Employment | ||
Employed (ref) | - | |
Unemployed | −4.31 (−3.04, −5.57) *** | |
Stroke | ||
No (ref) | - | |
Yes | −2.63 (−1.15, −4.11) ** | |
High Blood Pressure | ||
No (ref) | - | |
Yes | −1.51 (−0.30, −2.72) * | |
Emphysema | ||
No (ref) | - | |
Yes | −2.82 (−0.53, −5.12) * | |
Chronic Pain | ||
No (ref) | - | |
Yes | −4.50 (−3.50, −5.50) *** | |
Arthritis | ||
No (ref) | - | |
Yes | −3.77 (−2.52, −5.02) *** | |
Asthma | ||
No (ref) | - | |
Yes | −0.98 (−2.43, 0.47) | |
High Cholesterol | ||
No (ref) | - | |
Yes | −0.99 (−2.03, 0.05) | |
Coronary Heart Disease | ||
No (ref) | - | |
Yes | −2.36 (−4.76, 0.05) | |
Angina | ||
No (ref) | - | |
Yes | −0.35 (−2.41, 1.71) | |
Heart Attack | ||
No (ref) | - | |
Yes | 2.58 (0.48, 4.68) * | |
Heart Disease | ||
No (ref) | - | |
Yes | −1.99 (−4.67, 0.69) | |
Other Heart Disease | ||
No (ref) | - | |
Yes | −1.39 (−0.09, −2.70) * | |
Bronchitis | ||
No (ref) | - | |
Yes | −0.77 (−3.00, 1.47) | |
Cancer | ||
No (ref) | - | |
Yes | −2.59 (−1.17, −4.00) *** |
Unadjusted | Adjusted | |
---|---|---|
Estimate (95% CI) | Estimate (95% CI) | |
Food Security Status | ||
Food Secure (ref) | - | - |
Food Insecure | −8.75 (−7.45, −10.06) *** | −5.37 (−4.06, −6.68) *** |
Age | ||
18–44 (ref) | - | |
45–64 | 1.96 (0.54, 3.39) ** | |
65+ | 5.67 (4.01, 7.33) *** | |
Gender | ||
Male (ref) | - | |
Female | −0.85 (−0.08, −1.62) * | |
Education | ||
<High School (ref) | - | |
High School Diploma/GED | 1.36 (0.22, 2.50) * | |
College | 1.33 (0.17, 2.49) * | |
Race/Ethnicity | ||
Non-Hispanic White (ref) | - | |
Non-Hispanic Black | 1.30 (0.28, 2.31) * | |
Hispanic | 0.10 (−1.09, 1.29) | |
Other | −0.78 (−2.26, 0.71) | |
Marital Status | ||
Married (ref) | - | |
Widow/Divorce/Separated | −1.15 (−0.28, −2.02) * | |
Never Married | 0.76 (−0.36, 1.88) | |
Region | ||
Northeast (ref) | - | |
West | 1.10 (−0.39, 2.58) | |
South | 0.17 (−1.23, 1.57) | |
Midwest | −0.05 (−1.50, 1.40) | |
Poverty | ||
Poor/Near Negative (ref) | - | |
Near Poor | 0.19 (−1.66, 2.04) | |
Low Income | 1.77 (0.20, 3.34) * | |
Middle Income | 1.87 (0.36, 3.38) * | |
High Income | 2.70 (1.01, 4.40) ** | |
Insurance | ||
Private (ref) | - | |
Public | −1.76 (−0.68, −2.84) ** | |
Uninsured | −0.29 (−2.70, 2.12) | |
Employment | ||
Employed (ref) | - | |
Unemployed | −2.54 (−1.50, −3.58) *** | |
Stroke | ||
No (ref) | - | |
Yes | −0.46 (−1.76, 0.83) | |
High Blood Pressure | ||
No (ref) | - | |
Yes | −0.77 (−1.79, 0.25) | |
Emphysema | ||
No (ref) | - | |
Yes | −1.23 (−3.09, 0.63) | |
Chronic Pain | ||
No (ref) | - | |
Yes | −2.37 (−1.50, −3.24) *** | |
Arthritis | ||
No (ref) | - | |
Yes | −1.31 (−0.33, −2.28) ** | |
Asthma | ||
No (ref) | - | |
Yes | −1.06 (−2.28, 0.17) | |
High Cholesterol | ||
No (ref) | - | |
Yes | 0.36 (−0.62, 1.34) | |
Coronary Heart Disease | ||
No (ref) | - | |
Yes | 1.99 (−0.49, 4.46) | |
Angina | ||
No (ref) | - | |
Yes | −0.71 (−2.83, 1.42) | |
Heart Attack | ||
No (ref) | - | |
Yes | 1.59 (−0.27, 3.45) | |
Heart Disease | ||
No (ref) | - | |
Yes | −3.84 (−6.65, −1.03) | |
Other Heart Disease | ||
No (ref) | - | |
Yes | 0.59 (−0.55, 1.72) | |
Bronchitis | ||
No (ref) | - | |
Yes | −0.10 (−2.52, 2.31) | |
Cancer | ||
No (ref) | - | |
Yes | −0.20 (−1.20, 0.80) |
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Walker, R.J.; Egede, J.K.; Thorgerson, A.; Mosley-Johnson, E.; Campbell, J.A.; Egede, L.E. The Burden of Food Insecurity on Quality of Life in Adults with Diabetes. Nutrients 2024, 16, 3602. https://doi.org/10.3390/nu16213602
Walker RJ, Egede JK, Thorgerson A, Mosley-Johnson E, Campbell JA, Egede LE. The Burden of Food Insecurity on Quality of Life in Adults with Diabetes. Nutrients. 2024; 16(21):3602. https://doi.org/10.3390/nu16213602
Chicago/Turabian StyleWalker, Rebekah J., Joshua K. Egede, Abigail Thorgerson, Elise Mosley-Johnson, Jennifer A. Campbell, and Leonard E. Egede. 2024. "The Burden of Food Insecurity on Quality of Life in Adults with Diabetes" Nutrients 16, no. 21: 3602. https://doi.org/10.3390/nu16213602
APA StyleWalker, R. J., Egede, J. K., Thorgerson, A., Mosley-Johnson, E., Campbell, J. A., & Egede, L. E. (2024). The Burden of Food Insecurity on Quality of Life in Adults with Diabetes. Nutrients, 16(21), 3602. https://doi.org/10.3390/nu16213602