TY - JOUR
T1 - Scope and social determinants of food insecurity among adults with atherosclerotic cardiovascular disease in the United States
AU - Mahajan, Shiwani
AU - Grandhi, Gowtham R.
AU - Valero-Elizondo, Javier
AU - Mszar, Reed
AU - Khera, Rohan
AU - Acquah, Isaac
AU - Yahya, Tamer
AU - Virani, Salim S.
AU - Blankstein, Ron
AU - Blaha, Michael J.
AU - Cainzos-Achirica, Miguel
AU - Nasir, Khurram
N1 - Funding Information:
Dr Nasir is on the advisory board of Amgen, Novartis, Medicine Company, and his research is partly supported by the Jerold B. Katz Academy of Translational Research. Dr Virani reports grant funding from the US Department of Veterans Affairs, World Heart Federation, and Tahir and Jooma Family; and honoraria from American College of Cardiology. The remaining authors have no disclosures to report.
Publisher Copyright:
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2021/8/17
Y1 - 2021/8/17
N2 - BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) results in high out-of-pocket healthcare expenditures predis-posing 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 so-ciodemographic 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/sepa-rated (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.
AB - BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) results in high out-of-pocket healthcare expenditures predis-posing 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 so-ciodemographic 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/sepa-rated (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.
KW - Atherosclerotic cardiovascular disease
KW - Disparities
KW - Food insecurity
KW - Social determinants of health
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UR - http://www.scopus.com/inward/citedby.url?scp=85114351347&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.020028
DO - 10.1161/JAHA.120.020028
M3 - Article
C2 - 34387089
AN - SCOPUS:85114351347
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 16
M1 - e020028
ER -