Skip to main content Accessibility help
×
Home

Chronic disease burden predicts food insecurity among older adults

  • Jane Jih (a1), Irena Stijacic-Cenzer (a2), Hilary K Seligman (a3), W John Boscardin (a4), Tung T Nguyen (a1) and Christine S Ritchie (a2)...

Abstract

Objective

Increased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity.

Design

Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS.

Setting

USA.

Subjects

Respondents of the 2013 HRS HCNS with household incomes <300 % of the federal poverty line (n 3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0–1, 2–4, ≥5 conditions), with multiple chronic conditions (MCC) defined as ≥2 conditions.

Results

The prevalence of food insecurity was 27·8 %. Compared with those having 0–1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2–4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37).

Conclusions

A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Chronic disease burden predicts food insecurity among older adults
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Chronic disease burden predicts food insecurity among older adults
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Chronic disease burden predicts food insecurity among older adults
      Available formats
      ×

Copyright

Corresponding author

* Corresponding author: Email jane.jih@ucsf.edu

References

Hide All
1. Wolff, JL, Starfield, B & Anderson, G (2002) Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med 162, 22692276.
2. Schoenberg, NE, Kim, H, Edwards, W et al. (2007) Burden of common multiple-morbidity constellations on out-of-pocket medical expenditures among older adults. Gerontologist 47, 423437.
3. Vogeli, C, Shields, AE, Lee, TA et al. (2007) Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med 22, Suppl. 3, 391395.
4. Fried, VM, Bernstein, AB & Bush, MA (2012) Multiple chronic conditions among adults aged 45 and over: trends over the past 10 years. NCHS Data Brief issue 100, 18.
5. Seligman, HK, Laraia, BA & Kushel, MB (2010) Food insecurity is associated with chronic disease among low-income NHANES participants. J Nutr 140, 304310.
6. Seligman, HK, Jacobs, EA, Lopez, A et al. (2012) Food insecurity and glycemic control among low-income patients with type 2 diabetes. Diabetes Care 35, 233238.
7. Olson, CM (1999) Nutrition and health outcomes associated with food insecurity and hunger. J Nutr 129, 2S Suppl, 521S524S.
8. Ziliak, JP & Gundersen, C (2017) The State of Senior Hunger in America 2015: An Annual Report – Supplement. http://www.feedingamerica.org/research/senior-hunger-research/state-of-senior-hunger-supplement-2015.pdf (accessed November 2017).
9. Kendall, A, Olson, C & Frongillo, E (1996) Relationship of hunger and food insecurity to food availability and consumption. J Am Diet Assoc 96, 10191024.
10. Lee, JS & Frongillo, EA (2001) Nutritional and health consequences are associated with food insecurity among US elderly persons. J Nutr 131, 15031509.
11. Lee, JS, Fischer, JG & Johnson, MA (2010) Food insecurity, food and nutrition programs, and aging: experiences from Georgia. J Nutr Elder 29, 116149.
12. Lee, JS & Frongillo, EA Jr (2001) Factors associated with food insecurity among US elderly persons: importance of functional impairments. J Gerontol B Psychol Sci Soc Sci 56, issue 2, S94S99.
13. Tarasuk, V, Mitchell, A, McLaren, L et al. (2013) Chronic physical and mental health conditions among adults may increase vulnerability to household food insecurity. J Nutr 143, 17851793.
14. Berkowitz, SA, Seligman, HK & Choudhry, NK (2014) Treat or eat: food insecurity, cost-related medication underuse, and unmet needs. Am J Med 127, 303310.e3.
15. Bengle, R, Sinnett, S, Johnson, T et al. (2010) Food insecurity is associated with cost-related medication non-adherence in community-dwelling, low-income older adults in Georgia. J Nutr Elder 29, 170191.
16. Sattler, EL & Lee, JS (2013) Persistent food insecurity is associated with higher levels of cost-related medication nonadherence in low-income older adults. J Nutr Gerontol Geriatr 32, 4158.
17. Health and Retirement Study (2017) HRS data handbook. https://hrs.isr.umich.edu/about/data-book (accessed January 2018).
18. Health Care and Nutrition Study (2013) HCNS 2013 data description. http://www.hrsonline.isr.umich.edu/modules/meta/2013/hcns/desc/2013HCNS_data_description.pdf? (accessed January 2016).
19. Blumberg, S, Bialostosky, K, Hamilton, W et al. (1999) The effectiveness of a short form of the household food security scale. Am J Public Health 89, 12311234.
20. Huntley, AL, Johnson, R, Purdy, S et al. (2012) Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide. Ann Fam Med 10, 134141.
21. Health and Retirement Study (2016) HRS study design. http://www.hrsonline.isr.umich.edu/sitedocs/surveydesign.pdf? (accessed January 2016).
22. Sharkey, JR (2003) Risk and presence of food insufficiency are associated with low nutrient intakes and multimorbidity among homebound older women who receive home-delivered meals. J Nutr 133, 34853491.
23. Jeon, Y-H, Essue, B, Jan, S et al. (2009) Economic hardship associated with managing chronic illness: a qualitative inquiry. BMC Health Serv Res 9, 182.
24. Valtorta, NK & Hanratty, B (2013) Socioeconomic variation in the financial consequences of ill health for older people with chronic diseases: a systematic review. Maturitas 74, 313333.
25. Lynch, JW, Kaplan, GA & Shema, SJ (1997) Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. N Engl J Med 337, 18891895.
26. Gundersen, C (2013) Food insecurity is an ongoing national concern. Adv Nutr 4, 3641.
27. Ratcliffe, C & McKernan, S-M (2010) How Much Does SNAP Reduce Food Insecurity? Washington, DC: The Urban Institute.
28. Mabli, J, Ohls, J, Dragoset, L et al. (2013) Measuring the Effect of Supplemental Nutrition Assistance Program (SNAP) Participation on Food Security. Cambridge, MA: Mathematica Policy Research for US Department of Agriculture, Food and Nutrition Service.
29. Food Research and Action Center (2017) Closing the senior SNAP gaps. http://www.frac.org/blog/closing-senior-snap-gaps (accessed November 2017).
30. Cannon, M (2016) Screening and Interventions for Food Insecurity in Health Care Settings: State Strategies to Increase an Underutilized Practice in California. Oakland/Los Angeles, CA: California Food Policy Advocates.
31. Torres, J, De Marchis, E, Fichtenberg, C et al. (2017) Identifying Food Insecurity in Health Care Settings: A Review of the Evidence. San Francisco, CA: Social Interventions Research & Evaluation Network.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed