Department of Epidemiology, University of Washington, Seattle, WA98195, USA.
Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
Public Health Nutr. 2023 Jan;26(1):199-207. doi: 10.1017/S1368980022001240. Epub 2022 May 23.
Lower-income older adults with multiple chronic conditions (MCC) are highly vulnerable to food insecurity. However, few studies have considered how health care access is related to food insecurity among older adults with MCC. The aims of this study were to examine associations between MCC and food insecurity, and, among older adults with MCC, between health care access and food insecurity.
Cross-sectional study data from the 2019 Behavioral Risk Factor Surveillance System survey.
Washington State, USA.
Lower-income adults, aged 50 years or older ( 2118). MCC was defined as having ≥ 2 of 11 possible conditions. Health care access comprised three variables (unable to afford seeing the doctor, no health care coverage and not having a primary care provider (PCP)). Food insecurity was defined as buying food that did not last and not having money to get more.
The overall prevalence of food insecurity was 26·0 % and was 1·50 times greater (95 % CI 1·16, 1·95) among participants with MCC compared to those without MCC. Among those with MCC ( 1580), inability to afford seeing a doctor was associated with food insecurity (prevalence ratio (PR) 1·83; 95 % CI 1·46, 2·28), but not having health insurance (PR 1·49; 95 % CI 0·98, 2·24) and not having a PCP (PR 1·10; 95 % CI 0·77, 1·57) were not.
Inability to afford healthcare is related to food insecurity among older adults with MCC. Future work should focus on collecting longitudinal data that can clarify the temporal relationship between MCC and food insecurity.
患有多种慢性病（MCC）的低收入老年人群体极易面临食物不安全问题。然而，很少有研究考虑医疗保健的可及性与患有 MCC 的老年人食物不安全之间的关系。本研究旨在检验 MCC 与食物不安全之间的关联，以及在患有 MCC 的老年人中，医疗保健的可及性与食物不安全之间的关联。
来自 2019 年行为风险因素监测系统调查的横断面研究数据。
美国华盛顿州。
年龄在 50 岁或以上的低收入成年人（2118 人）。MCC 的定义是患有 11 种可能疾病中的≥2 种。医疗保健的可及性包括三个变量（无力负担看医生的费用、没有医疗保险覆盖和没有初级保健提供者（PCP））。食物不安全的定义是购买的食物无法持续供应且没有钱购买更多食物。
总的食物不安全发生率为 26.0%，与没有 MCC 的参与者相比，患有 MCC 的参与者的食物不安全发生率高 1.50 倍（95%CI 1.16，1.95）。在患有 MCC 的参与者中（1580 人），无力负担看医生与食物不安全相关（患病率比（PR）1.83；95%CI 1.46，2.28），但没有医疗保险（PR 1.49；95%CI 0.98，2.24）和没有 PCP（PR 1.10；95%CI 0.77，1.57）则不然。
无力负担医疗保健与患有 MCC 的老年人的食物不安全有关。未来的工作应重点收集能阐明 MCC 与食物不安全之间时间关系的纵向数据。
