Very low food security predicts obesity predominantly in California Hispanic men and women

AbstractObjectiveA high prevalence of food insecurity has persisted in the USA for the past two decades. Previous studies suggest that the association between food insecurity and obesity may vary by gender and race/ethnicity. We examined whether food insecurity was associated with BMI and obesity within gender and racial/ethnic groups in a large, diverse sample of low-income adults.DesignA cross-sectional analysis of a large population-based health survey. We compared the distribution of BMI and obesity by food security levels within gender and racial/ethnic categories.SettingData were derived from the 2003–2009 waves of the California Health Interview Survey.SubjectsThe study sample included 35 747 non-elderly adults with households ≤200 % of the federal poverty level.ResultsAmong Hispanic men, very low food security was associated with a 1·0 kg/m2 higher BMI (95 % CI 0·3, 1·7 kg/m2) and a 36 % higher prevalence of obesity (95 % CI 17, 58 %) after multivariate adjustment. Among Hispanic women, very low food security was associated with a 1·1 kg/m2 higher BMI (95 % CI 0·4, 1·9 kg/m2) and a 22 % higher prevalence of obesity (95 % CI 8, 38 %). Positive associations were also observed for Asian women and multi-racial men. No significant associations were observed for non-Hispanic whites, African Americans, Asian men or multi-racial women.ConclusionsOur results suggest that the association of food insecurity and obesity is limited to individuals of certain low-income, minority racial/ethnic groups. Whether targeted interventions to address food insecurity in these individuals may also decrease obesity risk deserves further investigation.

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Is participation in food and income assistance programmes associated with obesity in California adults? Results from a state-wide survey

Public Health Nutrition ◽

10.1017/s1368980010002090 ◽

2010 ◽

Vol 14 (4) ◽

pp. 645-652 ◽

Cited By ~ 39

Author(s):

Cindy W Leung ◽

Eduardo Villamor

Keyword(s):

Food Insecurity ◽

Low Income ◽

Economic Status ◽

Dietary Quality ◽

California Health Interview Survey ◽

Poverty Level ◽

Cross Sectional ◽

Assistance Program ◽

Socio Economic Status ◽

Prevalence Of Obesity

AbstractObjectivePublic assistance programmes may increase risk of obesity among adults. The current study assessed whether participation in the Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamp Program), Supplemental Security Income (SSI) or California Work Opportunities and Responsibilities to Kids (CalWorks) was associated with obesity, independent of socio-economic status and food insecurity.DesignA cross-sectional analysis of the 2007 Adult California Health Interview Survey. Outcome measures included BMI and obesity. Distribution of BMI and prevalence of obesity were compared by participation in each programme, using weighted linear and binomial regression models in which BMI or obesity was the outcome, respectively, and programme participation was the predictor.SettingA population survey of various health measures.SubjectsNon-institutionalized adults (n 7741) whose household income was ≤130 % of the federal poverty level.ResultsThe prevalence of obesity was 27·4 %. After adjusting for sociodemographic characteristics, food insecurity and participation in other programmes, the prevalence of obesity was 30 % higher in SNAP participants (95 % CI 6 %, 59 %; P = 0·01) than in non-participants. This association was more pronounced among men than women. SSI participation was related to an adjusted 50 % higher prevalence of obesity (95 % CI 27 %, 77 %; P < 0·0001) compared with no participation. SNAP and SSI participants also reported higher soda consumption than non-participants of any programme. CalWorks participation was not associated with obesity after multivariable adjustment.ConclusionsParticipation in SNAP or SSI was associated with obesity independent of food insecurity or socio-economic status. The suggestion that these associations may be mediated by dietary quality warrants further investigation among low-income populations.

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Accessibility of summer meals and the food insecurity of low-income households with children

Public Health Nutrition ◽

10.1017/s1368980016000033 ◽

2016 ◽

Vol 19 (11) ◽

pp. 2079-2089 ◽

Cited By ~ 11

Author(s):

Daniel P Miller

Keyword(s):

Food Security ◽

Food Insecurity ◽

Low Income ◽

Urban Areas ◽

California Health Interview Survey ◽

Lower Probability ◽

Geographic Accessibility ◽

Households With Children ◽

The Impact ◽

Low Income Households

AbstractObjectiveAlmost no previous research has examined the impact of the US Department of Agriculture’s (USDA) Summer Food Service Program and related Seamless Summer Option, which provide meals and snacks to low-income children over the summer. The present study investigated whether geographic accessibility of summer meals programme sites (a proxy for programme participation) was associated with food insecurity for low-income households.DesignThe study used data from the California Health Interview Survey (CHIS) and administrative data on summer meals sites in California. Geocoding was used to calculate driving time between CHIS households and nearby summer meals sites. Geographic accessibility was measured using a gravity model, which accounted for the spatially distributed supply of and demand for summer meals. Food insecurity and very low food security were measured using a standard six-item measure from the USDA.SubjectsLow-income families with children (n5394).SettingA representative surveillance study of non-institutionalized households in California.ResultsGeographic accessibility was not associated with food insecurity. However, geographic accessibility was associated with a significantly lower probability of very low food security in the full sample and among households with younger children and those living in less urban areas.ConclusionsThe USDA’s summer meals programme may be effective at reducing the most severe form of food insecurity for low-income households with children. Expanding the number of summer meals sites, the number of meals served at sites and sites’ hours of operation may be effective strategies to promote nutritional health over the summer months.

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Race and Sex Differences in the Association between Food Insecurity and Type 2 Diabetes

Ethnicity & Disease ◽

10.18865/ed.26.3.427 ◽

2016 ◽

Vol 26 (3) ◽

pp. 427 ◽

Cited By ~ 6

Author(s):

Sabrina Strings ◽

Yamini K. Ranchod ◽

Barbara Laraia ◽

Amani Nuru-Jeter

Keyword(s):

Type 2 Diabetes ◽

Food Security ◽

Food Insecurity ◽

African American Women ◽

Low Income ◽

White Women ◽

California Health Interview Survey ◽

Latino Men ◽

The Relationship

Objective: To examine whether the relationship between food insecurity (FI) and type 2 diabetes (T2D) varies by race/ethnicity and sex. Methods: We analyzed data from low-income adults participating in the 2009 and 2011 waves of the California Health Interview Survey (CHIS) (N=22,596). We used logistic regression models to estimate the sex and race-specific associations between FI and T2D. Results: We observed positive associations between low food security and T2D for White men (AOR: 1.9, 95% CI: 1.2, 3.2), and between very low food security and T2D for White women (AOR: 1.6 95% CI: 1.1, 2.5). In Latinas, we observed positive associations between both low food security (AOR: 1.7, 95% CI: 1.3, 2.2) and very low food security (AOR: 1.8, 95% CI: 1.2, 2.6) and T2D. We did not observe any associations between FI and T2D in Latino men, or African American women and men. Conclusion: The relationship between FI and T2D may be moderated by race and sex. For African Americans and Latino men, other distal factors may modify the effect of FI on rates of T2D. Ethn Dis. 2016;26(3):427-434; doi:10.18865/ ed.26.3.427

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Food Insecurity and Psychological Distress Among Former and Current Smokers With Low Income

American Journal of Health Promotion ◽

10.1177/0890117118784233 ◽

2018 ◽

Vol 33 (2) ◽

pp. 199-207 ◽

Cited By ~ 4

Author(s):

Jin E. Kim-Mozeleski ◽

Janice Y. Tsoh

Keyword(s):

Food Security ◽

Psychological Distress ◽

Food Insecurity ◽

Low Income ◽

Smoking Status ◽

Short Form ◽

Multiple Logistic Regression Analysis ◽

California Health Interview Survey ◽

Cross Sectional ◽

Distress Scale

Purpose: To examine how food insecurity and psychological distress interact in its association with smoking and to explore how food insecurity and psychological distress are associated with quitting smoking using quit ratio estimates. Design: Cross-sectional study. Setting: Data from the 2015 California Health Interview Survey. Participants: A total of 3007 lower income adults who have ever smoked. Measures: Ever smoking was defined as smoking 100+ cigarettes in the entire lifetime, with current smoking defined as smoking “every day” or “some days” and former smoking defined as smoking “not at all.” Psychological distress and food insecurity were measured by the 6-item K6 Psychological Distress Scale and the 6-item Food Security Survey Short Form, respectively. Analysis: Multiple logistic regression analysis was used to examine correlates of smoking status. Quit ratios (percentage of ever smokers who have quit) were calculated across study variables. Results: Reporting food insecurity with psychological distress was independently associated with lower odds of being a former smoker, compared to reporting food security without psychological distress. The quit ratio was lower among ever smokers reporting food insecurity with distress (41%) compared to ever smokers reporting food security without distress (63%). Conclusions: Specific conditions of impoverishment, such as food insecurity, interact with psychological distress in its association with continued smoking. Interventions to reduce socioeconomic disparities in smoking should consider the interacting role of food insecurity and psychological distress.

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Food Security and COVID-19: A Systematic Review of the First-Year Experience

Sustainability ◽

10.3390/su13095294 ◽

2021 ◽

Vol 13 (9) ◽

pp. 5294

Author(s):

Boglárka Anna Éliás ◽

Attila Jámbor

Keyword(s):

Systematic Review ◽

Food Security ◽

Food Insecurity ◽

Low Income ◽

Poverty Reduction ◽

First Year ◽

Structural Problem ◽

Global Food Security ◽

Global Food ◽

Low Income Households

For decades, global food security has not been able to address the structural problem of economic access to food, resulting in a recent increase in the number of undernourished people from 2014. In addition, the FAO estimates that the number of undernourished people drastically increased by 82–132 million people in 2020 due to the COVID-19 pandemic. To alleviate this dramatic growth in food insecurity, it is necessary to understand the nature of the increase in the number of malnourished during the pandemic. In order to address this, we gathered and synthesized food-security-related empirical results from the first year of the pandemic in a systematic review. The vast majority (78%) of the 51 included articles reported household food insecurity has increased (access, utilization) and/or disruption to food production (availability) was a result of households having persistently low income and not having an adequate amount of savings. These households could not afford the same quality and/or quantity of food, and a demand shortfall immediately appeared on the producer side. Producers thus had to deal not only with the direct consequences of government measures (disruption in labor flow, lack of demand of the catering sector, etc.) but also with a decline in consumption from low-income households. We conclude that the factor that most negatively affects food security during the COVID-19 pandemic is the same as the deepest structural problem of global food security: low income. Therefore, we argue that there is no need for new global food security objectives, but there is a need for an even stronger emphasis on poverty reduction and raising the wages of low-income households. This structural adjustment is the most fundamental step to recover from the COVID-19 food crises, and to avoid possible future food security crises.

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Food insecurity, coping strategies and glucose control in low-income patients with diabetes

Public Health Nutrition ◽

10.1017/s1368980015002323 ◽

2015 ◽

Vol 19 (6) ◽

pp. 1103-1111 ◽

Cited By ~ 30

Author(s):

Victoria L Mayer ◽

Kevin McDonough ◽

Hilary Seligman ◽

Nandita Mitra ◽

Judith A Long

Keyword(s):

Food Insecurity ◽

Coping Strategies ◽

Low Income ◽

Glucose Control ◽

Economic Stress ◽

Poverty Level ◽

Cross Sectional ◽

Assistance Program ◽

Patients With Diabetes ◽

And Coping

AbstractObjectiveTo examine the relationship between food insecurity and coping strategies (actions taken to manage economic stress) hypothesized to worsen glucose control in patients with diabetes.DesignUsing a cross-sectional telephone survey and clinical data, we compared food-insecure and food-secure individuals in their use of coping strategies. Using logistic regression models, we then examined the association between poor glucose control (glycated Hb, HbA1c≥8·0 %), food insecurity and coping strategies.SettingAn urban medical centre, between June and December 2013.SubjectsFour hundred and seven adults likely to be low income (receiving Medicaid or uninsured and/or residing in a zip code with >30 % of the population below the federal poverty level) with type 2 diabetes.ResultsOf respondents, 40·5 % were food insecure. A significantly higher percentage of the food-insecure group reported use of most examined coping strategies, including foregone medical care, participation in the Supplemental Nutrition Assistance Program (SNAP)) and use of emergency food programmes. Food insecurity was associated with poor glucose control (OR=2·23; 95 % CI 1·22, 4·10); coping strategies that were more common among the food insecure were not associated with poor glucose control. Among the food insecure, receipt of SNAP was associated with lower risk of poor glucose control (OR=0·27; 95 % CI 0·09, 0·80).ConclusionsWhile food insecurity was associated with poor glucose control, most examined coping strategies did not explain this relationship. However, receipt of SNAP among food-insecure individuals was associated with better diabetes control, suggesting that such programmes may play a role in improving health.

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Imagining Her Future: Diversity in Mothers’ Socialization Goals for Their Adolescent Daughters

Journal of Cross-Cultural Psychology ◽

10.1177/0022022117696802 ◽

2017 ◽

Vol 48 (4) ◽

pp. 593-610 ◽

Cited By ~ 2

Author(s):

Jennifer Ramirez ◽

Linda Oshin ◽

Stephanie Milan

Keyword(s):

United States ◽

African American ◽

Ethnic Groups ◽

Low Income ◽

The United States ◽

Social Traits ◽

Socialization Goals ◽

Racial Ethnic ◽

Q Sort

According to developmental niche theory, members of different cultural and ethnic groups often have distinct ideas about what children need to become well-adapted adults. These beliefs are reflected in parents’ long-term socialization goals for their children. In this study, we test whether specific themes that have been deemed important in literature on diverse families in the United States (e.g., Strong Black Woman [SBW], marianismo, familismo) are evident in mothers’ long-term socialization goals. Participants included 192 mothers of teenage daughters from a low-income city in the United States (58% Latina, 22% African American, and 20% European American [EA]/White). Socialization goals were assessed through a q-sort task on important traits for a woman to possess and content analysis of open-ended responses about what values mothers hoped they would transmit to their daughters as they become adults. Results from ANCOVAs and logistic regression indicate significant racial/ethnic differences on both tasks consistent with hypotheses. On the q-sort task, African American mothers put more importance on women possessing traits such as independence than mothers from other racial/ethnic groups. Similarly, they were more likely to emphasize self-confidence and strength in what they hoped to transmit to their daughters. Contrary to expectation, Latina mothers did not emphasize social traits on the q-sort; however, in open-ended responses, they were more likely to focus on the importance of motherhood, one aspect of marianismo and familismo. Overall, results suggest that these mothers’ long-term socialization goals incorporate culturally relevant values considered important for African American and Latino families.

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Food Security in Hawai‘i

Food and Power in Hawai'i ◽

10.21313/hawaii/9780824858537.003.0003 ◽

2016 ◽

Author(s):

George Kent

Keyword(s):

Food Security ◽

Food Insecurity ◽

State Government ◽

Low Income ◽

Food Production ◽

Local Food ◽

The State ◽

The Poor ◽

Self Sufficiency ◽

Low Income Consumers

This chapter challenges the uncritical pursuit of food self-sufficiency that has been rationalized as increasing the state’s preparedness against shipping disruption. It argues that this effort might increase food’s cost, and reiterates the point that local food is not necessarily fair as low-income consumers could be sidelined in the push for food localization. In contrast to the enthusiasm for promoting agriculture and local food production in the state, relatively little has been done in addressing food insecurity of the poor, especially by the state government. Food democracy needs to consider food security for all—particularly the poor and the marginalized.

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Perceptions of the Food Environment and Access among Predominantly Black Low-Income Residents of Rural Louisiana Communities

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155340 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5340

Author(s):

Denise Holston ◽

Jessica Stroope ◽

Matthew Greene ◽

Bailey Houghtaling

Keyword(s):

Food Security ◽

Focus Group ◽

Food Insecurity ◽

Low Income ◽

Food Environment ◽

Food Access ◽

The United States ◽

Grocery Store ◽

Assistance Program ◽

Nutrition Assistance

Food insecurity in rural settings is complex and not fully understood, especially from the perspective of low-income and Black residents. The goal of this study was to use qualitative methods to better understand experiences with food access and perceptions of the food environment among low-income, predominately Black rural Louisiana residents in the United States. Data were collected from focus group discussions (FGD) and focus group intake forms. Study participants were all rural residents eligible to receive at least one nutrition assistance program. FGD questions focused on perceptions of the food environment, with an emphasis on food access. Participants (n = 44) were predominately Black and female. Over half (n = 25) reported running out of food before the end of the month. Major themes included: store choice, outshopping, methods of acquiring foods other than the grocery store, and food insecurity. Concerns around price, quality, and transportation emerged as factors negatively impacting food security. Understanding residents’ perceptions and experiences is necessary to inform contextually appropriate and feasible policy and practice interventions that address the physical environment and social conditions that shape the broader physical food environment in order to achieve equitable food access and food security.

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Differences in overall survival for patients with cholangiocarcinoma: Racial/ethnic disparity or socioeconomic factors?

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.380 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 380-380 ◽

Cited By ~ 1

Author(s):

Rachel M Lee ◽

Yuan Liu ◽

Mohammad Yahya Zaidi ◽

Adriana Carolina Gamboa ◽

Maria C. Russell ◽

...

Keyword(s):

Overall Survival ◽

Socioeconomic Factors ◽

Ethnic Groups ◽

Racial Differences ◽

Low Income ◽

Census Data ◽

Private Insurance ◽

Cancer Data ◽

Race Ethnicity ◽

Racial Ethnic

380 Background: Inequities in cancer survival are well documented. Whether disparities in overall survival (OS) result from inherent racial differences in underlying disease biology or socioeconomic factors (SEF) is not known. Our aim was to define the association of race/ethnicity and SEF with OS in pts with cholangiocarcinoma (CCA). Methods: Pts with CCA of all sites and stages in the National Cancer Data Base (2004-14) were included. Racial/ethnic groups were defined as non-Hispanic White (NH-W), non-Hispanic Black (NH-B), Asian, and Hispanic. Income and education were based on census data for pts’ zip code. Income was defined as high (³$63,000) vs low ( < $63,000). Primary outcome was OS. Results: 27,151 pts were included with a mean age of 68 yrs; 51% were male. 78% were NH-W, 8% NH-B, 6% Asian, and 6% Hispanic. 56% had Medicare, 33% private insurance, 7% Medicaid, and 4% were uninsured. 67% had high income. 21% lived in an area where > 20% of adults did not finish high school. NH-B and Hispanic pts had more unfavorable SEF including uninsured status, low income, and less formal education than NH-W and Asian pts (all p < 0.001). They were also younger, more likely to be female and to have metastatic disease (all p < 0.001). Despite this, NH-B race and Hispanic ethnicity were not associated with decreased OS. Male sex, older age, non-private insurance, low income, lower education, non-academic facility, location outside the Northeast, higher Charlson-Deyo score, worse grade, larger tumor size, and higher stage were all associated with decreased OS (all p < 0.001). On MV analysis, along with adverse pathologic factors, type of insurance (p = 0.003), low income (p < 0.001), and facility type and location of treatment (p < 0.001) remained associated with decreased OS; non-white race/ethnicity was not. Conclusions: Disparities in survival exist in CCA, however they are not driven by race/ethnicity. Non-privately insured and low-income pts had decreased OS, as did pts treated at non-academic centers and outside the Northeast. This suggests that decreased ability to access and afford care results in worse outcomes, rather than biological differences amongst racial/ethnic groups.

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