Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Background Atherosclerotic cardiovascular disease (ASCVD) results in high out‐of‐pocket healthcare expenditures predisposing to food insecurity. However, the burden and determinants of food insecurity in this population are unknown. Methods and Results Using 2013 to 2018 National Health Interview Su...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.020028 |
| _version_ | 1797606808326504448 |
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| author | Shiwani Mahajan Gowtham R. Grandhi Javier Valero‐Elizondo Reed Mszar Rohan Khera Isaac Acquah Tamer Yahya Salim S. Virani Ron Blankstein Michael J. Blaha Miguel Cainzos‐Achirica Khurram Nasir |
| author_facet | Shiwani Mahajan Gowtham R. Grandhi Javier Valero‐Elizondo Reed Mszar Rohan Khera Isaac Acquah Tamer Yahya Salim S. Virani Ron Blankstein Michael J. Blaha Miguel Cainzos‐Achirica Khurram Nasir |
| author_sort | Shiwani Mahajan |
| collection | DOAJ |
| description | Background Atherosclerotic cardiovascular disease (ASCVD) results in high out‐of‐pocket healthcare expenditures predisposing to food insecurity. However, the burden and determinants of food insecurity in this population are unknown. Methods and Results Using 2013 to 2018 National Health Interview Survey data, we evaluated the prevalence and sociodemographic determinants of food insecurity among adults with ASCVD in the United States. ASCVD was defined as self‐reported diagnosis of coronary heart disease or stroke. Food security was measured using the 10‐item US Adult Food Security Survey Module. Of the 190 113 study participants aged 18 years or older, 18 442 (adjusted prevalence 8.2%) had ASCVD, representing ≈20 million US adults annually. Among adults with ASCVD, 2968 or 14.6% (weighted ≈2.9 million US adults annually) reported food insecurity compared with 9.1% among those without ASCVD (P<0.001). Individuals with ASCVD who were younger (odds ratio [OR], 4.0 [95% CI, 2.8–5.8]), women (OR, 1.2 [1.0–1.3]), non‐Hispanic Black (OR, 2.3 [1.9–2.8]), or Hispanic (OR, 1.6 [1.2–2.0]), had private (OR, 1.8 [1.4–2.3]) or no insurance (OR, 2.3 [1.7–3.1]), were divorced/widowed/separated (OR, 1.2 [1.0–1.4]), and had low family income (OR, 4.7 [4.0–5.6]) were more likely to be food insecure. Among those with ASCVD and 6 of these high‐risk characteristics, 53.7% reported food insecurity and they had 36‐times (OR, 36.2 [22.6–57.9]) higher odds of being food insecure compared with those with ≤1 high‐risk characteristic. Conclusion About 1 in 7 US adults with ASCVD experience food insecurity, with more than 1 in 2 adults reporting food insecurity among the most vulnerable sociodemographic subgroups. There is an urgent need to address the barriers related to food security in this population. |
| first_indexed | 2024-03-11T05:20:18Z |
| format | Article |
| id | doaj.art-d143ac41a71e466fa046ffb5fdaec4a2 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-11T05:20:18Z |
| publishDate | 2021-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-d143ac41a71e466fa046ffb5fdaec4a22023-11-17T17:57:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-08-01101610.1161/JAHA.120.020028Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United StatesShiwani Mahajan0Gowtham R. Grandhi1Javier Valero‐Elizondo2Reed Mszar3Rohan Khera4Isaac Acquah5Tamer Yahya6Salim S. Virani7Ron Blankstein8Michael J. Blaha9Miguel Cainzos‐Achirica10Khurram Nasir11Center for Outcomes Research and Evaluation Yale New Haven Hospital New Haven CTDepartment of Medicine MedStar Union Memorial Hospital Baltimore MDDivision of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TXCenter for Outcomes Research and Evaluation Yale New Haven Hospital New Haven CTCenter for Outcomes Research and Evaluation Yale New Haven Hospital New Haven CTCenter for Outcomes Research Houston Methodist Research Institute Houston TXDivision of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TXMichael E. DeBakey Veterans Affairs Medical Center & Section of Cardiology Baylor College of Medicine Houston TXCardiovascular Imaging Program Cardiovascular Division and Department of Radiology Brigham and Women's Hospital Boston MAThe Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease Baltimore MDDivision of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TXDivision of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TXBackground Atherosclerotic cardiovascular disease (ASCVD) results in high out‐of‐pocket healthcare expenditures predisposing to food insecurity. However, the burden and determinants of food insecurity in this population are unknown. Methods and Results Using 2013 to 2018 National Health Interview Survey data, we evaluated the prevalence and sociodemographic determinants of food insecurity among adults with ASCVD in the United States. ASCVD was defined as self‐reported diagnosis of coronary heart disease or stroke. Food security was measured using the 10‐item US Adult Food Security Survey Module. Of the 190 113 study participants aged 18 years or older, 18 442 (adjusted prevalence 8.2%) had ASCVD, representing ≈20 million US adults annually. Among adults with ASCVD, 2968 or 14.6% (weighted ≈2.9 million US adults annually) reported food insecurity compared with 9.1% among those without ASCVD (P<0.001). Individuals with ASCVD who were younger (odds ratio [OR], 4.0 [95% CI, 2.8–5.8]), women (OR, 1.2 [1.0–1.3]), non‐Hispanic Black (OR, 2.3 [1.9–2.8]), or Hispanic (OR, 1.6 [1.2–2.0]), had private (OR, 1.8 [1.4–2.3]) or no insurance (OR, 2.3 [1.7–3.1]), were divorced/widowed/separated (OR, 1.2 [1.0–1.4]), and had low family income (OR, 4.7 [4.0–5.6]) were more likely to be food insecure. Among those with ASCVD and 6 of these high‐risk characteristics, 53.7% reported food insecurity and they had 36‐times (OR, 36.2 [22.6–57.9]) higher odds of being food insecure compared with those with ≤1 high‐risk characteristic. Conclusion About 1 in 7 US adults with ASCVD experience food insecurity, with more than 1 in 2 adults reporting food insecurity among the most vulnerable sociodemographic subgroups. There is an urgent need to address the barriers related to food security in this population.https://www.ahajournals.org/doi/10.1161/JAHA.120.020028atherosclerotic cardiovascular diseasedisparitiesfood insecuritysocial determinants of health |
| spellingShingle | Shiwani Mahajan Gowtham R. Grandhi Javier Valero‐Elizondo Reed Mszar Rohan Khera Isaac Acquah Tamer Yahya Salim S. Virani Ron Blankstein Michael J. Blaha Miguel Cainzos‐Achirica Khurram Nasir Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atherosclerotic cardiovascular disease disparities food insecurity social determinants of health |
| title | Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States |
| title_full | Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States |
| title_fullStr | Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States |
| title_full_unstemmed | Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States |
| title_short | Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States |
| title_sort | scope and social determinants of food insecurity among adults with atherosclerotic cardiovascular disease in the united states |
| topic | atherosclerotic cardiovascular disease disparities food insecurity social determinants of health |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.020028 |
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