Department of Geography and Planning, University of Toronto Mississauga, Room 3207, Davis Building, 1867 Inner Circle, Mississauga, ON, L5L IC6, Canada.
Department of Nutritional Sciences, University of Toronto, Room 5366A, Medical Sciences Building 5th Floor, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
Soc Sci Med. 2019 Dec;243:112636. doi: 10.1016/j.socscimed.2019.112636. Epub 2019 Oct 22.
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.
研究表明，残疾与更高的家庭粮食不安全（HFI）发生率之间存在关联。尽管经济和政治背景（包括生活成本和残疾社会援助）可能会对此关系产生影响，但尚未对此关系的地域差异进行探索。本研究考虑到人口构成、背景和集体影响的可能作用，在加拿大内部和跨加拿大检查了行动障碍与 HFI 之间的关联。利用来自 2007/08、2009/10、2013/14 和 2015/16 年加拿大社区健康调查的 217094 名成年人的数据，多元逻辑回归模型检查了在控制社会人口统计学因素和居住地理（即省份、地区和城乡地位）的情况下，行动障碍与 HFI 之间的关联。对 14353 名患有行动障碍的接受调查的成年人进行了后续分析，以检查与该人群中 HFI 相关的地理和社会人口统计学因素。在调整年龄、性别和居住地理因素以及调整其他社会人口统计学特征后，患有行动障碍的成年人 HFI 的几率增加了 3.85（95%CI：3.49-4.24）。在加拿大各地，行动障碍成年人的 HFI 几率更高。在调整年龄和性别后，与安大略省相比，纽芬兰省、艾伯塔省和萨斯喀彻温省的行动障碍成年人 HFI 的几率明显降低，而在控制其他社会人口统计学因素后，魁北克省的 HFI 几率降低。在该人群中，HFI 的大部分变化归因于社会经济因素和年龄，这表明需要实施扶贫战略，以减少整个人口中对 HFI 的脆弱性。
