Department of Consumer Science and Convergence Program for Social Innovation, Sungkyunkwan University, Seoul, South Korea.
Int J Equity Health. 2023 Aug 4;22(1):148. doi: 10.1186/s12939-023-01937-z.
Food insecurity is a significant risk factor for chronic and infectious diseases. It is also a barrier to accessing healthcare because food insecurity tends to co-occur with other socioeconomic disadvantages. The objective of this study is to examine whether food insecure individuals in South Korea can access desired level of healthcare when needed.
This repeated cross-sectional study used data from the 2013-2015 and 2019-2021 waves of the Korean National Health and Nutrition Examination Survey. Multivariable logistic regression models were used to examine the association between household food insecurity and two indicators of unmet healthcare needs - any experience of forgoing medical service and the reasons for unmet needs (problems with availability, acceptability, and accessibility). Covariates indicating predisposing, enabling, and need factors were included in the regression analyses.
Of the 19,394 participants aged 19-64 years, 4.5% were moderately food insecure, 0.9% were severely food insecure, and 9.3% reported unmet healthcare needs. In the adjusted model, moderate food insecurity (OR, 1.47; 95% CI, 1.19-1.82) and severe food insecurity (OR, 3.32; 95% CI, 2.27-4.85) were associated with higher odds of unmet healthcare needs in a dose-graded manner. These associations were largely due to the increased odds of accessibility-related unmet needs among participants with moderate (OR, 2.31; 95% CI, 1.68-3.19) and severe food insecurity (OR, 6.15; 95% CI, 3.91-9.68).
Food insecurity was associated with higher odds of unmet healthcare needs among Korean adults. Competing life demands may have a cumulative impact on health over the short and long term. Efforts to address trade-offs between healthcare needs and food insecurity may improve the health and well-being of marginalized populations.
食品不安全是导致慢性和传染病的重要危险因素。它也是获得医疗保健的障碍，因为食品不安全往往与其他社会经济劣势同时存在。本研究的目的是检验韩国的食品不安全个体在需要时是否能够获得所需水平的医疗保健。
本重复横断面研究使用了 2013-2015 年和 2019-2021 年韩国国家健康和营养检查调查的资料。多变量逻辑回归模型用于检验家庭食品不安全与两个未满足医疗保健需求指标之间的关联——任何放弃医疗服务的经历以及未满足需求的原因（可及性、可接受性和可及性方面的问题）。回归分析中包括了表示倾向、使能和需求因素的协变量。
在 19394 名 19-64 岁的参与者中，4.5%为中度食品不安全，0.9%为严重食品不安全，9.3%报告未满足医疗保健需求。在调整后的模型中，中度食品不安全（OR，1.47；95%CI，1.19-1.82）和严重食品不安全（OR，3.32；95%CI，2.27-4.85）与未满足医疗保健需求的可能性呈剂量依赖性增加。这些关联主要归因于中度（OR，2.31；95%CI，1.68-3.19）和严重食品不安全（OR，6.15；95%CI，3.91-9.68）参与者获得可及性相关未满足需求的可能性增加。
食品不安全与韩国成年人未满足医疗保健需求的可能性增加有关。短期和长期来看，竞争的生活需求可能会对健康产生累积影响。解决医疗保健需求和食品不安全之间的权衡可能会改善弱势群体的健康和福祉。
