Date of Award

5-3-2023

Degree Type

Dissertation

Degree Name

Doctor of Public Health (DrPH)

Department

Public Health

First Advisor

Lia Scott, PhD

Second Advisor

Christine Stauber, PhD

Third Advisor

Shereitte Stokes, PhD

Abstract

Studies of the health impact of low food security among adults are limited and generally focus on the association between low food security and one chronic illness. These studies do not examine the full range of food security status which include high, marginal, low, and very low. Past studies have focused only on two groups: food secure and food insecure. We, therefore, examined the association between the four levels of food security and six chronic conditions: hypertension, diabetes, coronary heart disease (CHD), cancer, asthma, and kidney disease. Our study compared two nationally representative population-based samples from the National Health and Nutrition Examination Survey (NHANES). A total of 3,709 and 3,161 adults aged 20-64 were included from NHANES 2007-2008 and 2017-2018, respectively. We estimated the association between food security status and each chronic disease using logistic regression. We adjusted the models to account for differences in age, gender, race/ethnicity, educational attainment, and income. In 2007-2008, in our adjusted analysis, having marginal food security was associated with significantly higher odds of having CHD. Having low food security was associated with significantly higher odds of having CHD and kidney disease. Having very low food security was associated with higher odds of having hypertension, asthma, CHD, and kidney. In 2017-2018, those with marginal food security were not found to be statistically significantly associated with the presence of any of the chronic conditions examined. However, having low food security was associated with significantly higher odds of having hypertension and diabetes. Having very low food security was again associated with significantly higher odds of having hypertension, asthma, CHD, and kidney disease. Those with lower income were more likely to report asthma, diabetes, CHD, and kidney disease. Also, non-Hispanic Blacks were more likely to report most conditions compared to non-Hispanic Whites. This study shows the strong association between low food security and chronic diseases in working-age US adults. Food security should be increased through a more concerted effort to link individuals to available resources.

DOI

https://doi.org/10.57709/35386106

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