美国波多黎各人生存压力与食物不安全的关联研究：从基线到 5 年随访
Psychosocial Risk Factors for Food Insecurity in Puerto Ricans Living in the USA from Baseline to 5-Year Follow-Up.
机构信息
Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA.
Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.
出版信息
J Nutr. 2020 Aug 1;150(8):2199-2203. doi: 10.1093/jn/nxaa177.
BACKGROUND
Food insecurity is prevalent among Puerto Rican adults in the USA and is associated with adverse psychosocial outcomes. However, the direction of this association has not been established in this understudied population.
OBJECTIVES
In this study, we aimed to examine the longitudinal association between a group of psychosocial risk factors and subsequent food insecurity in a cohort of Puerto Rican adults.
METHODS
Secondary analysis was conducted using data from the prospective Boston Puerto Rican Health Study. A total of 517 Puerto Rican participants aged 45-75 y in the Boston area who were food secure at baseline, and who completed food security surveys at baseline and 5 y were included. Psychosocial factors, including depressive symptoms, stress, tangible social support, and acculturation were assessed with validated instruments. Multivariable logistic regression models were used to examine the risk of food insecurity at 5 y, as a function of psychosocial factors at baseline and their changes over 5 y, adjusting for age, sex, education, baseline and change in total annual household income, and in family size.
RESULTS
The cumulative incidence of food insecurity at 5 y was 12.6%. The odds of incident food insecurity was significantly associated with baseline depressive symptom score [OR = 1.78 (1.16, 2.76) per each 10 score units], with change in depressive symptom score [OR = 1.50 (1.07, 2.09) per each 10-unit increase], and with change in perceived stress [OR = 1.59 (1.01, 2.51) per each 10-unit increase], after adjusting for potential confounders.
CONCLUSION
In this cohort of Puerto Rican adults, depressive symptoms at baseline, and increases in depressive symptoms and perceived stress over 5 y were associated with a higher risk of food insecurity. Psychosocial health and environment appear to play important roles in predicting risk of food insecurity in the Puerto Rican community.
背景
食物不安全在美国的波多黎各成年人中普遍存在，并与不良的社会心理结果有关。然而，在这个研究不足的人群中，这种关联的方向尚未确定。
目的
在这项研究中，我们旨在检验一组社会心理风险因素与波多黎各成年人队列中随后发生的食物不安全之间的纵向关联。
方法
使用来自前瞻性波士顿波多黎各健康研究的数据进行二次分析。共纳入 517 名年龄在 45-75 岁之间、基线时食物安全且在基线和 5 年时完成食物安全调查的波士顿地区波多黎各参与者。使用经过验证的工具评估社会心理因素，包括抑郁症状、压力、有形社会支持和文化适应。多变量逻辑回归模型用于检验 5 年后食物不安全的风险，其函数为基线时的社会心理因素及其在 5 年内的变化，调整年龄、性别、教育、基线和家庭总收入变化以及家庭规模。
结果
5 年后食物不安全的累积发生率为 12.6%。发生食物不安全的几率与基线时抑郁症状评分显著相关[每增加 10 个评分单位，比值比（OR）为 1.78（1.16，2.76）]，与抑郁症状评分的变化相关[每增加 10 个单位，OR 为 1.50（1.07，2.09）]，与感知压力的变化相关[每增加 10 个单位，OR 为 1.59（1.01，2.51）]，调整了潜在混杂因素。
结论
在这个波多黎各成年人队列中，基线时的抑郁症状以及 5 年内抑郁症状和感知压力的增加与更高的食物不安全风险相关。社会心理健康和环境似乎在预测波多黎各社区的食物不安全风险方面发挥着重要作用。
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