Food insecurity, social needs, and smoking status among patients in a county hospital system
Tobacco use in the U.S. is increasingly concentrated among populations with socioeconomic disadvantages such as food insecurity. Building on prior studies showing that food insecurity increases odds of cigarette smoking, the current study sought to examine how food insecurity and other social needs,...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-10-01
|
| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335522002704 |
| _version_ | 1811267039309856768 |
|---|---|
| author | Jin E. Kim-Mozeleski Kevin M. Chagin Ashwini R. Sehgal James E. Misak Susan M. Fuehrer |
| author_facet | Jin E. Kim-Mozeleski Kevin M. Chagin Ashwini R. Sehgal James E. Misak Susan M. Fuehrer |
| author_sort | Jin E. Kim-Mozeleski |
| collection | DOAJ |
| description | Tobacco use in the U.S. is increasingly concentrated among populations with socioeconomic disadvantages such as food insecurity. Building on prior studies showing that food insecurity increases odds of cigarette smoking, the current study sought to examine how food insecurity and other social needs, particularly financial strain, transportation barriers, and housing/utility insecurity, were associated with smoking status among adult patients seen in a county hospital system. We analyzed data from the electronic health record of patients from The MetroHealth System (Cleveland, Ohio, USA), covering a two-year period since implementation of social determinants of health assessments (2019–2021; N = 45,151 patients). Logistic regression analyses were used to examine associations with smoking status. Compared to the overall smoking prevalence (21 %), smoking was higher among patients screening for transportation barriers (41 %), financial strain (39 %), food insecurity (34 %), and housing/utility insecurity (27 %). Each of these social needs was independently associated with increased odds of current smoking (all p < 0.05). Smoking prevalence increased sequentially as the number of social needs increased; with each addition of a social need, there was a dose-response association with higher odds of current smoking (adjusted ORs ranged from 1.56 to 3.76, all p < 0.001), and current smoking specifically among ever smoking patients (adjusted ORs ranged from 1.39 to 3.01, all p < 0.001). There was substantial overlap among several social needs and smoking status. Alongside improving access to evidence-based cessation treatments and services, the findings raise the possibility that addressing social needs might reduce barriers to quitting and thereby reduce tobacco use disparities. |
| first_indexed | 2024-04-12T20:55:18Z |
| format | Article |
| id | doaj.art-ee1ec80128964b3b90ecb7748c826668 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-04-12T20:55:18Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-ee1ec80128964b3b90ecb7748c8266682022-12-22T03:17:01ZengElsevierPreventive Medicine Reports2211-33552022-10-0129101963Food insecurity, social needs, and smoking status among patients in a county hospital systemJin E. Kim-Mozeleski0Kevin M. Chagin1Ashwini R. Sehgal2James E. Misak3Susan M. Fuehrer4Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA; Corresponding author at: Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, 11000 Cedar Ave, BioEnterprise 451, Cleveland, OH 44106, USA.The Institute for H.O.P.E.TM, The MetroHealth System, Cleveland, OH, USAThe Institute for H.O.P.E.TM, The MetroHealth System, Cleveland, OH, USA; The Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH, USAThe Institute for H.O.P.E.TM, The MetroHealth System, Cleveland, OH, USAThe Institute for H.O.P.E.TM, The MetroHealth System, Cleveland, OH, USATobacco use in the U.S. is increasingly concentrated among populations with socioeconomic disadvantages such as food insecurity. Building on prior studies showing that food insecurity increases odds of cigarette smoking, the current study sought to examine how food insecurity and other social needs, particularly financial strain, transportation barriers, and housing/utility insecurity, were associated with smoking status among adult patients seen in a county hospital system. We analyzed data from the electronic health record of patients from The MetroHealth System (Cleveland, Ohio, USA), covering a two-year period since implementation of social determinants of health assessments (2019–2021; N = 45,151 patients). Logistic regression analyses were used to examine associations with smoking status. Compared to the overall smoking prevalence (21 %), smoking was higher among patients screening for transportation barriers (41 %), financial strain (39 %), food insecurity (34 %), and housing/utility insecurity (27 %). Each of these social needs was independently associated with increased odds of current smoking (all p < 0.05). Smoking prevalence increased sequentially as the number of social needs increased; with each addition of a social need, there was a dose-response association with higher odds of current smoking (adjusted ORs ranged from 1.56 to 3.76, all p < 0.001), and current smoking specifically among ever smoking patients (adjusted ORs ranged from 1.39 to 3.01, all p < 0.001). There was substantial overlap among several social needs and smoking status. Alongside improving access to evidence-based cessation treatments and services, the findings raise the possibility that addressing social needs might reduce barriers to quitting and thereby reduce tobacco use disparities.http://www.sciencedirect.com/science/article/pii/S2211335522002704TobaccoSocial needsSocial determinants of healthHealth disparitiesElectronic health record |
| spellingShingle | Jin E. Kim-Mozeleski Kevin M. Chagin Ashwini R. Sehgal James E. Misak Susan M. Fuehrer Food insecurity, social needs, and smoking status among patients in a county hospital system Preventive Medicine Reports Tobacco Social needs Social determinants of health Health disparities Electronic health record |
| title | Food insecurity, social needs, and smoking status among patients in a county hospital system |
| title_full | Food insecurity, social needs, and smoking status among patients in a county hospital system |
| title_fullStr | Food insecurity, social needs, and smoking status among patients in a county hospital system |
| title_full_unstemmed | Food insecurity, social needs, and smoking status among patients in a county hospital system |
| title_short | Food insecurity, social needs, and smoking status among patients in a county hospital system |
| title_sort | food insecurity social needs and smoking status among patients in a county hospital system |
| topic | Tobacco Social needs Social determinants of health Health disparities Electronic health record |
| url | http://www.sciencedirect.com/science/article/pii/S2211335522002704 |
| work_keys_str_mv | AT jinekimmozeleski foodinsecuritysocialneedsandsmokingstatusamongpatientsinacountyhospitalsystem AT kevinmchagin foodinsecuritysocialneedsandsmokingstatusamongpatientsinacountyhospitalsystem AT ashwinirsehgal foodinsecuritysocialneedsandsmokingstatusamongpatientsinacountyhospitalsystem AT jamesemisak foodinsecuritysocialneedsandsmokingstatusamongpatientsinacountyhospitalsystem AT susanmfuehrer foodinsecuritysocialneedsandsmokingstatusamongpatientsinacountyhospitalsystem |