Murkey Jamie A, Gaston Symielle A, Alhasan Dana M, Payne Christopher W, Jackson W Braxton, Jackson Chandra L
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA.
Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, 27703, USA.
BMC Public Health. 2024 May 3;24(1):1220. doi: 10.1186/s12889-024-18655-y.
Minoritized racial/ethnic groups and women in the United States (US) are disproportionately burdened by food insecurity, which likely contributes to disparities in cardiovascular health (CVH). Disparities are projected to widen due to the worsening climate crisis that is straining the agricultural system including food supplies. Nonetheless, studies have not investigated the relationship between food security status and 'ideal' CVH in a large, nationally-representative and racially/ethnically diverse US sample.
We investigated household food security status in relation to 'ideal' CVH among US adults (N = 157,001) using 2014-2018/2020 National Health Interview Survey data. Food security status was defined as very low, low, marginal, or high. A summed score of 4 health behaviors and 3 clinical factors totaling 7 different measures was dichotomized (yes/no) to assess modified 'ideal' CVH (mICVH). Using Poisson regression with robust variance, we estimated prevalence ratios (PRs) and 95% CIs of mICVH by household food security status. We stratified models by sex/gender and race/ethnicity. Very low food security prevalence was higher among non-Hispanic (NH)-Black (8.0%) compared to Hispanic/Latinx (5.1%), NH-White (3.1%) and NH-Asian (1.7%) adults. The association between very low versus high food security and mICVH was stronger among women (PR = 0.23 [95% CI: 0.17-0.31]) than men (PR = 0.48 [95% CI: 0.35-0.66]). Compared to NH-White adults with high food security, racially/ethnically minoritized groups with very low to high food security were generally less likely (range: [PR = 0.25[95% CI: 0.14-0.44] - [PR = 0.88 [95% CI: 0.79-0.97]) to meet mICVH criteria.
Food insecurity was associated with lower mICVH prevalence and racially/ethnically minoritized groups were disproportionately burdened.
在美国，少数族裔群体和女性面临粮食不安全问题的负担过重，这可能导致心血管健康（CVH）方面的差异。由于气候危机不断恶化，给包括粮食供应在内的农业系统带来压力，预计这种差异还会扩大。尽管如此，尚未有研究在美国一个具有全国代表性且种族/族裔多样化的大样本中调查粮食安全状况与“理想”CVH之间的关系。
我们使用2014 - 2018/2020年美国国家健康访谈调查数据，调查了美国成年人（N = 157,001）中家庭粮食安全状况与“理想”CVH的关系。粮食安全状况被定义为极低、低、边缘或高。将4种健康行为和3种临床因素的总分（共7项不同指标）进行二分法（是/否）划分，以评估修正后的“理想”CVH（mICVH）。使用稳健方差的泊松回归，我们估计了按家庭粮食安全状况划分的mICVH的患病率比（PRs）和95%置信区间（CIs）。我们按性别和种族/族裔对模型进行分层。与西班牙裔/拉丁裔（5.1%）、非西班牙裔白人（NH - White，3.1%）和非西班牙裔亚裔（NH - Asian，1.7%）成年人相比，非西班牙裔黑人（NH - Black，8.0%）中粮食安全极低的患病率更高。粮食安全极低与高的情况与mICVH之间的关联在女性中（PR = 0.23 [95% CI：0.17 - 0.
