Mobility impairments and geographic variation in vulnerability to household food insecurity.

Studies indicate an association between disability and higher rates of household food insecurity (HFI). Geographic variation in this relationship has not been explored despite the potential influence of economic and political contexts, including costs of living and disability social assistance. This study examines the association between mobility impairment and HFI within and across Canada considering the possible role of population composition, contextual, and collective influences. Using data from 217,094 adults from the 2007/08, 2009/10, 2013/14, and 2015/16 Canadian Community Health Survey, multivariate logistic regression models examined associations between mobility impairment and HFI controlling for socio-demographic factors and geography of residence (i.e., province, region, and urban/rural status). Subsequent analysis of 14,353 surveyed adults with mobility impairments was conducted to examine geographic and socio-demographic factors associated with HFI in this population. Adults with mobility impairments had elevated odds of HFI of 3.85 (95% CI: 3.49-4.24), when adjusting for age, sex, and geography of residence and 2.11 (95% CI: 1.89-2.35) adjusting for additional socio-demographic characteristics. Across Canada, mobility impaired adults experienced greater odds of HFI. Significantly lower odds of HFI were found for mobility impaired adults living in Newfoundland, Alberta, and Saskatchewan compared to Ontario when adjusting for age and sex, and in Quebec when controlling for additional socio-demographic factors. Socioeconomic factors and age accounted for most variation in HFI in this population, suggesting the importance of poverty reduction strategies that reduce vulnerability to HFI across the population.