Mathematica, Cambridge, MA, USA.
J Nutr. 2020 Dec 10;150(12):3152-3160. doi: 10.1093/jn/nxaa286.
In 2018, 14.3 million US households experienced food insecurity, which has been linked to negative health outcomes such as depression and anxiety, diabetes, and hypertension. This connection is particularly important for older adults, who are at greater risk than younger adults for developing certain health conditions.
We estimated the association between food insecurity and the use of health services for adverse health events over a 12-mo observation period following survey interview for a nationally representative group of older adults participating in the congregate meal (CM) and home-delivered meal (HDM) programs.
We analyzed data from the Nutrition Services Program (NSP) Outcomes Survey matched to Medicare claims and enrollment data in 2015-2016 for a nationally representative sample of 626 CM or HDM recipients ages 67 y and older. We used logistic regression analysis controlling for demographic characteristics, prior health events, and geography to estimate the association between food insecurity and use of health services, including emergency department visits, inpatient stays, skilled nursing facility stays, and home healthcare episodes. We used ordinary least squares regression analysis to estimate the association between food insecurity and Medicare spending.
Food insecurity was associated with an average increased likelihood of using health services for adverse health events of 16% (95% CI: 1%, 32%) for HDM participants. Food insecurity was associated with an average increased likelihood of emergency department visits of 24% (95% CI: 6%, 41%) for CM participants and 20% (95% CI: 5%, 36%) for HDM participants. There was no observed increase in likelihood of using the other health services. Food-insecure participants were less likely to have a skilled nursing facility stay.
Food insecurity is associated with an increased likelihood of use of health services for adverse health events in older adult participants in meal service programs.
2018 年，美国有 1430 万户家庭经历了粮食不安全，这与抑郁和焦虑、糖尿病和高血压等负面健康结果有关。这种联系对于老年人尤为重要，因为他们比年轻人更容易出现某些健康状况。
我们估计了在参与集体用餐（CM）和家庭送餐（HDM）计划的全国代表性老年人群体的调查访谈后 12 个月的观察期内，粮食不安全与因不良健康事件使用健康服务之间的关联。
我们分析了 2015-2016 年全国代表性的 626 名 CM 或 HDM 接受者的营养服务计划（NSP）结果调查数据，这些接受者的年龄在 67 岁及以上，并与医疗保险索赔和登记数据相匹配。我们使用逻辑回归分析控制人口统计学特征、既往健康事件和地理位置，以估计粮食不安全与健康服务使用之间的关联，包括急诊就诊、住院、熟练护理机构入住和家庭保健疗程。我们使用普通最小二乘法回归分析来估计粮食不安全与医疗保险支出之间的关联。
粮食不安全与 HDM 参与者因不良健康事件使用健康服务的可能性平均增加了 16%（95%CI：1%，32%）。粮食不安全与 CM 参与者急诊就诊的可能性平均增加了 24%（95%CI：6%，41%）和 HDM 参与者急诊就诊的可能性平均增加了 20%（95%CI：5%，36%）。没有观察到使用其他健康服务的可能性增加。粮食不安全的参与者更不可能入住熟练护理机构。
粮食不安全与膳食服务计划中老年人参与者因不良健康事件使用健康服务的可能性增加有关。
