College of Medicine, University of Central Florida, Orlando, Florida.
Disability, Aging, and Technology Cluster, College of Nursing, University of Central Florida, Orlando, Florida.
Sci Diabetes Self Manag Care. 2023 Aug;49(4):291-302. doi: 10.1177/26350106231173674. Epub 2023 May 24.
The purpose of the study was to examine factors associated with food insecurity among Medicare beneficiaries with type 2 diabetes.
The 2019 Medicare Current Beneficiary Survey Public Use File of beneficiaries ≥65 years old with type 2 diabetes (n = 1343) was analyzed. A binary variable was created to represent food insecurity (1 = food insecurity, 0 = without food insecurity) with ≥2 affirmative responses adapting an established algorithm of the United States Department of Agriculture food insecurity questionnaire. A survey-weighted logistic model was performed to examine factors (ie, sociodemographic characteristics, health status, and insurance coverage) associated with food insecurity.
Approximately 11.6% of study Medicare beneficiaries with type 2 diabetes reported food insecurity. Non-Hispanic Black beneficiaries were more likely to report food insecurity than non-Hispanic White beneficiaries. Beneficiaries with incomes < $25 000 were more likely to report food insecurity than those with higher incomes. Beneficiaries enrolled in Medicare Advantage programs (vs traditional Medicare), having Medicare-Medicaid dual eligibility (vs nondual), and living with instrumental activities of daily living or activities of daily living limitations (vs without) were also more likely to report food insecurity than their respective counterparts.
Sociodemographic disparities in food insecurity were observed among Medicare beneficiaries with type 2 diabetes. Implementation of screening protocols, interventions related to social determinants of health, and the diabetes care continuum may mitigate the prevalence of food insecurity in this demographic.
本研究旨在探讨与 2 型糖尿病 Medicare 受益人群中食物不安全相关的因素。
分析了 2019 年 Medicare 现行受益人体检公共使用文件中≥65 岁的 2 型糖尿病（n=1343）受益人群。创建了一个二元变量来表示食物不安全（1=食物不安全，0=没有食物不安全），方法是采用美国农业部食物不安全问卷的既定算法对≥2 个肯定回答进行改编。采用调查加权逻辑模型，检验与食物不安全相关的因素（即社会人口统计学特征、健康状况和保险覆盖范围）。
约 11.6%的研究 Medicare 2 型糖尿病受益人群报告存在食物不安全。非西班牙裔黑人受益人群比非西班牙裔白人受益人群更有可能报告食物不安全。收入<25000 美元的受益人群比收入较高的受益人群更有可能报告食物不安全。与传统 Medicare 相比，参加 Medicare Advantage 计划、具有 Medicare-Medicaid 双重资格（而非非双重资格）以及存在日常生活活动或日常生活活动受限的受益人群比各自的对照人群更有可能报告食物不安全。
在 2 型糖尿病 Medicare 受益人群中观察到了食物不安全的社会人口统计学差异。实施筛选方案、与健康社会决定因素相关的干预措施以及糖尿病护理连续体可能会减轻这一人群中食物不安全的发生率。
