Food insecurity tied to increased risk for mortality in US adults
People who experience food insecurity in the United States may be more likely to experience all-cause and cardiovascular morality, according to a study published in Health Promotion Practice.
Food insecurity affects a substantial number of Americans. According to the study authors, more than one-tenth of the United States population experiences food insecurity each year, and 14.3 million U.S. households were food insecure in 2018.
Researchers analyzed data from adult participants in the nationally representative 1999-2010 National Health and Nutrition Examination Survey and collected mortality data on participants through 2015.
Among the 25,247 participants included in the study, 17.4% reported being food insecure. Researchers found that 11% of participants who reported food insecurity died during an average follow-up period of 10.2 years. In comparison, 12.3% of those who did not report food insecurity died during follow-up.
Among food-insecure individuals, 17.3% of all deaths were attributed to CVD.
After adjusting for age and gender, researchers determined that the risk for mortality in food-insecure participants was 58% higher compared with those who were not food insecure (adjusted HR = 1.58; 95% CI, 1.25-2.01).
When adjusting for participants’ age, gender and demographic and health risk factors, researchers found that those who reported food insecurity were 46% (HR = 1.46; 95% CI, 1.23-1.72) more likely to experience all-cause mortality and 75% (HR = 1.75; 95% CI, 1.19-2.57) more likely to experience CV mortality compared with participants who were food secure.
Healio Primary Care spoke with study author Jagdish Khubchandani, MBBS, PhD, MPH, of the department of public health science at New Mexico State University, to learn more about the findings and how primary care physicians should screen patients for food insecurity.
Q: What is the importance of studying food insecurity in the United States?
A: Healthy foods and exercise are the two most cost-effective and reliable medicines for the general population in preventing a variety of chronic diseases. We have seen studies on the prevalence and distribution of food insecurity in the American population. We wanted to explore the long-term impact of food insecurity by accounting for several demographic and health risk factors.
Q: How could these findings impact guidelines on CVD risk assessment?
A: We hope that CVD risk assessment includes a module on food quantity and quality of persons at risk. Given that food-insecure people may also consume poor quality diet when they get food, this can be a key factor in determining overall risk of mortality and severe CVD outcomes in food-insecure people.
Q: How should PCPs screen for food insecurity in their patients?
A: According to published studies, large-scale population-based or routine screening is difficult, but feasible and acceptable to patients. However, food insecurity-related discussion with patients and clinics is vital if it can change or influence, and if it may make care more patient centered. Screening can be done by a variety of validated screening measures with ease and efficiency. However, the challenge is, what next when someone is found to be in profound hunger? Collaborations between community organizations and health care systems is a promising approach for addressing food insecurity and a team approach to healthcare will address this.
Q: How could the COVID-19 pandemic impact food insecurity in the U.S.? Should PCPs screen patients for food insecurity more often moving forward?
A: The numbers on food insecurity due to the COVID-19 pandemic are yet to be documented or published. However, we must be assured, unfortunately, the number of food insecure will increase. Communities have come into action on their own and are doing well in assisting the hungry, but more government intervention may be needed. As mentioned earlier, large-scale screening may not help on routine basis. However, judgment has to be made based on patient [socioeconomic status] and clinical management required for certain at-risk groups that we identified.