Branley Claire E, Goulding Melissa, Tisminetzky Mayra, Lemon Stephenie C
Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Ave North, 01655, Worcester, Massachusetts, USA.
Division of Preventative and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
BMC Public Health. 2025 Apr 22;25(1):1487. doi: 10.1186/s12889-025-22714-3.
Multimorbidity among parents, guardians, and caregivers may increase the risk of household food insecurity, which would negatively impact both parents and children. However, limited research has been done to evaluate this relationship among this population. To fill this gap, we examined the association between multimorbidity and food insecurity among U.S. parents.
Cross-sectional data from 2019 to 2022 of the National Health Interview Survey were analyzed. Parents, guardians, and caregivers with complete data (N = 26,579) were included. Multimorbidity is defined as having 2 or more conditions. In this study, multimorbidity was categorized as 2 or 3 + conditions from a sum of 11 chronic conditions: hypertension, hyperlipidemia, diabetes, arthritis, stroke, cancer, asthma, depression, anxiety, chronic obstructive pulmonary disease, and heart disease. The presence of food insecurity was defined in four nominal categories (secure, marginal food security, low food security, very low food security). Survey-weighted multinomial regression was used to assess the association of multimorbidity with food insecurity categories, controlling for sociodemographic characteristics. The association between physical versus physical-mental comorbidities and food insecurity was also analyzed.
The mean study sample age was 38.8 years, 51% were women and 53% were non-Hispanic White race/ethnicity. Nearly half (49%) had ≥ 1 chronic condition; 23% had 1, 14% had 2, and 13% had 3+. The most common pair of chronic conditions among parents was depression and anxiety, and most common triad was depression, anxiety, and hypertension. After controlling for potential confounders, we found that parents with 3 + conditions had a higher risk of marginal (OR 1.75, 95% CI 1.47-2.10), low (OR 2.20, 95% CI 1.75-2.75), and very low food security (OR 4.1, 95% CI 3.2-5.2) compared to parents with no conditions. Differences were seen in the odds of food insecurity among parents with mental and physical conditions, as opposed to physical comorbidities alone.
Our findings suggest a higher risk of food insecurity in parents with multimorbidity. Parents with multimorbidity (especially those with comorbid depression and anxiety disorders) may be a key population to identify and intervene on food insecurity to improve health and well-being among US families.
父母、监护人及照料者的多种疾病并存可能会增加家庭粮食不安全的风险，这会对父母和孩子都产生负面影响。然而，针对这一人群中这种关系的评估研究有限。为填补这一空白，我们研究了美国父母中多种疾病并存与粮食不安全之间的关联。
分析了2019年至2022年美国国家健康访谈调查的横断面数据。纳入了拥有完整数据的父母、监护人及照料者（N = 26,579）。多种疾病并存定义为患有两种或更多疾病。在本研究中，多种疾病并存根据11种慢性病的总和分为2种或3种及以上疾病：高血压、高脂血症、糖尿病、关节炎、中风、癌症、哮喘、抑郁症、焦虑症、慢性阻塞性肺疾病和心脏病。粮食不安全的存在分为四个名义类别（安全、边缘粮食安全、低粮食安全、极低粮食安全）。使用调查加权多项回归来评估多种疾病并存与粮食不安全类别之间的关联，并控制社会人口学特征。还分析了身体疾病与身心共病与粮食不安全之间的关联。
研究样本的平均年龄为38.8岁，51%为女性，53%为非西班牙裔白人种族/族裔。近一半（49%）患有≥1种慢性病；23%患有1种，14%患有2种，13%患有3种及以上。父母中最常见的慢性病组合是抑郁症和焦虑症，最常见的三联症是抑郁症、焦虑症和高血压。在控制潜在混杂因素后，我们发现患有3种及以上疾病的父母与无疾病的父母相比，处于边缘粮食不安全（OR 1.75，95% CI 1.47 - 2.10）、低粮食不安全（OR 2.20，95% CI 1.75 - 2.75）和极低粮食不安全（OR 4.1，95% CI 3.2 - 5.2）的风险更高。在患有身心疾病的父母与仅患有身体共病的父母中，粮食不安全的几率存在差异。
我们的研究结果表明，患有多种疾病的父母粮食不安全风险更高。患有多种疾病（尤其是患有抑郁症和焦虑症共病的父母）可能是识别和干预粮食不安全问题以改善美国家庭健康和福祉的关键人群。
