Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA.
Nutrients. 2021 Oct 29;13(11):3896. doi: 10.3390/nu13113896.
Individuals experience food insecurity when they worry about or have limited access to nutritious foods. Food insecurity negatively impacts older adults' health. Social exclusion is a theoretical framework describing how unequal access to rights, resources, and capabilities results in political, economic, social, and cultural vulnerability, which leads to health disparities. We used the Health and Retirement Study to cross-sectionally examine associations between vulnerability and experiencing food insecurity in adults 50 years and older using the social exclusion framework. We tested the association between experiencing food insecurity and indicators of political, economic, social, and cultural vulnerability using logistic regression controlling for demographic and health-related factors. Analyses were performed with all respondents and sub-group of respondents with incomes less than 400% of the federal poverty level (FPL). Assets (OR = 0.97 in both samples), income (OR = 0.85, 0.80 in 400% FPL sub-sample), perceived positive social support from other family (OR = 0.86, 0.84 in 400% FPL sub-sample), and perceived everyday discrimination (OR = 1.68, 1.82 in 400% FPL sub-sample) were significantly associated with food insecurity. Perceived positive social support from spouses, children, or friends and U.S. citizenship status were not significantly associated with food insecurity. Further research is needed to define and measure each dimension of vulnerability in the social exclusion framework. Interventions and policies designed to prevent food insecurity should address these vulnerabilities.
当个人担心或无法获得营养食品时，就会经历食物不安全。食物不安全对老年人的健康产生负面影响。社会排斥是一种理论框架，用于描述不平等地获得权利、资源和能力如何导致政治、经济、社会和文化脆弱性，从而导致健康差距。我们使用健康和退休研究，在横断面使用社会排斥框架检验了脆弱性与 50 岁及以上成年人经历食物不安全之间的关联。我们使用逻辑回归检验了经历食物不安全与政治、经济、社会和文化脆弱性指标之间的关联，控制了人口统计学和健康相关因素。对所有受访者和收入低于联邦贫困线（FPL）400%的受访者亚组进行了分析。资产（两个样本中的 OR = 0.97）、收入（OR = 0.85，400%FPL 亚组中的 OR = 0.80）、来自其他家庭成员的积极社会支持（OR = 0.86，400%FPL 亚组中的 OR = 0.84）和日常歧视（OR = 1.68，400%FPL 亚组中的 OR = 1.82）与食物不安全显著相关。来自配偶、子女或朋友的积极社会支持和美国公民身份与食物不安全没有显著关联。需要进一步研究来定义和衡量社会排斥框架中脆弱性的每个维度。旨在预防食物不安全的干预措施和政策应解决这些脆弱性。
