Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA.
Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA.
Nutr Metab Cardiovasc Dis. 2022 Jul;32(7):1590-1608. doi: 10.1016/j.numecd.2022.03.025. Epub 2022 Apr 1.
The primary objective of this study is to conduct a systematic review of existing literature on the association between food insecurity and housing instability with CVD and its subtypes-related outcomes. Summarizing the comprehensive evidence for independent/interchangeable relationship of food and housing instability with CVD outcomes may inform specific interventions strategies to reduce CVD-risk.
The search focused on English-language articles in PubMed/Medline, from January 1, 2010, to June 1, 2021, with restriction to the US adult population. We included studies estimating the association between food insecurity or/and housing instability(exposure) and CVD-subtypes-related health outcomes (outcome). The study methodological quality was assessed using the Study Quality Assessment Tools (SQAT). Nineteen studies met eligibility criteria, consisted of 15 cross-sectional and 4 cohort studies. Of total studies, 7 examined housing instability, 11 studies focused on food insecurity, and one examined both. Food insecurity/housing instability was associated with increased overall CVD-mortality rate and greater healthcare cost utilization, while evidence were mixed for hospital readmission rate. By subtype, stroke mortality was greater with food insecurity but not with housing instability. The likelihood of myocardial infarction, coronary heart disease, and congestive heart failure was greater with food insecurity. Although mortality with MI was higher with housing instability, readmission and surgical procedure rates were significantly lower than housing stable adults.
Findings from this review suggest an urgent need to test the impact of screening for food and housing insecurities, referral services, and community engagement for CV health, within clinical and public health settings.
Prospero CRD4202123352.
本研究的主要目的是对现有关于食物不安全和住房不稳定与心血管疾病（CVD）及其亚型相关结局之间关联的文献进行系统回顾。总结食物和住房不稳定与 CVD 结局之间独立/可互换关系的综合证据，可能为减少 CVD 风险提供具体的干预策略。
搜索重点是 2010 年 1 月 1 日至 2021 年 6 月 1 日期间在 PubMed/Medline 发表的英文文章，仅限于美国成年人群。我们纳入了评估食物不安全或/和住房不稳定（暴露）与 CVD 亚型相关健康结局（结局）之间关联的研究。使用研究质量评估工具（SQAT）评估研究方法学质量。符合入选标准的研究有 19 项，包括 15 项横断面研究和 4 项队列研究。在所有研究中，有 7 项研究探讨了住房不稳定，11 项研究集中于食物不安全，1 项研究同时探讨了这两个问题。食物不安全/住房不稳定与整体 CVD 死亡率增加和更高的医疗保健成本利用相关，而住院再入院率的证据则不一致。按亚型划分，食物不安全与中风死亡率增加有关，但与住房不稳定无关。心肌梗死、冠心病和充血性心力衰竭的发生风险与食物不安全有关。尽管住房不稳定与心肌梗死的死亡率较高，但再入院和手术率明显低于住房稳定的成年人。
本综述的结果表明，迫切需要在临床和公共卫生环境中测试对食物和住房不安全进行筛查、转介服务和社区参与对心血管健康的影响。
PROSPERO CRD4202123352。
