Assessing the relationship between food insecurity and mortality among U.S. adults. Ann Epidemiol 2019 Apr;32:43-48
Date
02/26/2019Pubmed ID
30799207Pubmed Central ID
PMC6441375DOI
10.1016/j.annepidem.2019.01.014Scopus ID
2-s2.0-85061809553 (requires institutional sign-in at Scopus site) 42 CitationsAbstract
PURPOSE: Significant evidence supports a relationship between food insecurity and health, but little work has investigated its relationship on all-cause mortality within a high resource country, such as the United States.
METHODS: Data from the 2003-2010 National Health and Nutrition Examination Survey was matched to National Death Index information. Cox models were used to study the relationship between mortality and food insecurity, adjusting for relevant covariates in a sequential manner (demographics, comorbidities, lifestyle variables, body mass index). Food insecurity was used as dichotomous and as four categories.
RESULTS: Of 20,918 participants, 11.6% (representing 208,789,244 U.S. residents) were food insecure. When food insecurity was dichotomized, there was 49% higher odds of mortality after adjusting for demographics (HR, 1.49; 95% CI, 1.19-1.87). After adjusting for comorbidities, the HR remained significant, but lost significance with adjustment for lifestyle factors and body mass index (HR, 1.15; 95% CI, 0.94-1.42). However, marginal food security lost significance after adjustment for lifestyle variables.
CONCLUSIONS: Food insecurity significantly impacts all-cause mortality in the United States; however, lifestyle may explain this relationship. Interventions should account for level of severity when creating targeted programs.
Author List
Walker RJ, Chawla A, Garacci E, Williams JS, Mendez C, Ozieh MN, Egede LEAuthors
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinCarlos Eduardo Mendez Castrillo MD Associate Professor in the Medicine department at Medical College of Wisconsin
Mukoso Nwamaka Ozieh MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin
Joni Williams MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Cross-Sectional Studies
Female
Food Supply
Humans
Male
Middle Aged
Mortality
Nutrition Surveys
Poverty
Proportional Hazards Models
Social Determinants of Health
Socioeconomic Factors
Young Adult
