Tolzman Casey, Rooney Brenda, Duquette R Daniel, Rees Keely
WMJ. 2014 Aug;113(4):139-43.
The US Department of Agriculture has identified an area in La Crosse, Wisconsin as a food desert-a low-income area with a low level of access to a grocery store or healthy, affordable food outlet. The purpose of this study was to determine the prevalence and potential predictors of severe food insecurity in this area.
Questionnaires assessing food insecurity and perceived barriers to accessing adequate nutrition were sent out to 2,068 households located within the food desert in La Crosse. Data was analyzed to examine correlations between severe food insecurity and demographics, certain health behaviors, and perceived barriers to nutrition.
Overall food insecurity existed in 33.9% of households: severe food insecurity with hunger in 14.6%, and without hunger in 19.3%. Significant correlations to severe food insecurity included health insurance status (Medicaid vs private insurance, OR 3.5), renting a home (OR 5.23), identifying the cost of healthy foods as a significant barrier (OR 2.97), having no transportation to a store (OR 3.09), not having enough money (OR 22.88), and currently smoking (OR 3.60).
Severe food insecurity was much higher in this population than expected. Clinicians should consider the patient's ability to access and afford healthy food as part of the patient's health history, as well as considering individual and population solutions.
美国农业部已将威斯康星州拉克罗斯的一个地区确定为食品荒漠——一个低收入地区，居民获取杂货店或健康、平价食品店的机会有限。本研究的目的是确定该地区严重粮食不安全状况的患病率及其潜在预测因素。
向拉克罗斯食品荒漠地区的2068户家庭发放了评估粮食不安全状况以及获取充足营养的感知障碍的问卷。对数据进行分析，以检验严重粮食不安全状况与人口统计学特征、某些健康行为以及营养感知障碍之间的相关性。
总体而言，33.9%的家庭存在粮食不安全状况：14.6%的家庭存在伴有饥饿的严重粮食不安全状况，19.3%的家庭存在不伴有饥饿的严重粮食不安全状况。与严重粮食不安全状况显著相关的因素包括健康保险状况（医疗补助与私人保险，比值比为3.5）、租房（比值比为5.23）、认为健康食品成本是重大障碍（比值比为2.97）、没有前往商店的交通工具（比值比为3.09）、没有足够的钱（比值比为22.88）以及目前吸烟（比值比为3.60）。
该人群中严重粮食不安全状况比预期高得多。临床医生应将患者获取和负担健康食品的能力作为患者健康史的一部分加以考虑，并考虑个体和群体层面的解决方案。
