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Bradley SE, Heuer JN, Hahm B, Pettey K, Besterman-Dahan K. "Just Food doesn't Do It": Understanding Food Insecurity Among Rural Veterans in the United States. Ecol Food Nutr 2024; 63:564-584. [PMID: 39097942 DOI: 10.1080/03670244.2024.2387339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Food security among rural veteran populations is an understudied subject. This study uses qualitative data from 106 semi-structured interviews conducted with staff from programs at the United States Department of Veterans Affairs (VA) and other federal agencies, staff from non-governmental organizations (NGOs), food security researchers, and food insecure veterans to identify the barriers to and facilitators for rural veteran food security. Barriers identified included external, structural barriers that exist in rural areas; internal barriers to using food assistance, such as feeling stigmatized; and barriers related to other social determinants of health, including a lack of education, employment, or housing stability.
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Affiliation(s)
- Sarah E Bradley
- Center for Healthcare Outcomes & Policy (CHOP) Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Research Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Jacquelyn N Heuer
- Research Service, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
| | - Bridget Hahm
- Research Service, Edward Hines, Jr. VA Hospital, Hines, Illinois, USA
| | - Kristin Pettey
- Office of Rural Health, Veterans Rural Health Resource Center, Salt Lake City, Utah, USA
| | - Karen Besterman-Dahan
- Mental Health, VISN 5 Mental Illness Research, Education and Clinical Center, Baltimore, Maryland, USA
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Gyasi RM, Asiedu HB, Siaw LP, Nyaaba E, Affum-Osei E, Lamptey RB, Muhonja F, Arthur DD, Asamoah E, Nimoh M, Adu-Gyamfi S. Food insecurity and mobility difficulty in middle-aged and older adults: The importance of bio-psychosocial factors. J Psychosom Res 2024; 184:111849. [PMID: 38950509 DOI: 10.1016/j.jpsychores.2024.111849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Food insecurity has been associated with mobility difficulty (MD) in old age. However, there is a scarcity of research on this topic from low- and middle-income countries, while the bio-psychological factors underlying this association are largely unknown. We investigated the food insecurity-MD link in Ghana and explored how sleep, anxiety, loneliness, and physical activity (PA) mediate the association. METHODS Community-based, representative cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behavior Study were analyzed (N = 1201; Mage = 66.5; women = 63%). MD was assessed with items from the SF-36 of the Medical Outcomes Study. We assessed food insecurity with items on hunger and breakfast-skipping frequency due to lack of food and resources. Adjusted OLS and mediation models via bootstrapping technique evaluated the associations. RESULTS Results revealed the expected association between food insecurity and MD, such that greater food insecurity was significantly and positively associated with MD across paths (from β = 0.33 to β = 0.42, p < .001). Analyses of indirect effects showed that sleep problems (27.8%), anxiety (15.5%), loneliness (17.5%), and PA (18.0%) mediated the association between food insecurity and MD. Cross-level interactions revealed that food insecurity significantly modified the link between each mediator and MD. CONCLUSIONS Our data provide novel evidence that bio-psychological mechanisms may underlie the food insecurity-MD link and should, therefore, be considered relevant targets for interventions to prevent/manage MD in later life.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Hubert Bimpeh Asiedu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Nyaaba
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Affum-Osei
- Department of Human Resources, School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Bruce Lamptey
- College of Science Library, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Faith Muhonja
- School of Public Health, Mount Kenya University, Kenya
| | - Dominic Degraft Arthur
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Asamoah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Nimoh
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Adu-Gyamfi
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Fernandez-Perez M, Aparco JP, Alarco JJ. [Head of household disability can increase household food insecurity: an analysis of a Colombian population survey]. CAD SAUDE PUBLICA 2024; 40:e00208723. [PMID: 39166561 PMCID: PMC11338598 DOI: 10.1590/0102-311xes208723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/15/2024] [Accepted: 06/04/2024] [Indexed: 08/23/2024] Open
Abstract
This study investigated the association between head of household disability and the severity of food insecurity in Colombian households during 2017. A secondary data analysis was conducted based on 2017 Colombian National Quality of Life Survey (ECV 2017). As the independent variable, disability was assessed using questions from the Washington group, whereas the dependent variable - food insecurity - was measured by the Latin American and Caribbean Food Security Scale (ELCSA). Sociodemographic confounding variables and variables related to food insecurity were included. Association was analyzed by ordinal logistic regression, and the odds ratio (OR) was estimated with its 95% confidence intervals (95%CI). All calculations considered the complex sampling of ECV 2017. Data from 8,488 heads of household were included. A total of 9.2% of the participants had some type of disability and 41.8% reported some level of household food insecurity. Households with a head of household with some disability were 30% more likely to develop severe food insecurity compared with households with a head of household without disabilities (OR = 1.30; 95%CI: 1.07-1.59), adjusted for multiple confounding variables. In 2017, Colombian households with heads of household with disabilities were more likely to develop severe food insecurity. It is essential to implement nutritional assistance programs aimed at vulnerable populations, such as people with disabilities.
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Affiliation(s)
| | - Juan Pablo Aparco
- Centro Nacional de Alimentación Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Perú
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - J Jhonnel Alarco
- Disability Epidemiology Research Group, Universidad Científica del Sur, Lima, Perú
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Pillay M, Kara R, Govindasamy P, Motala R. Food security and disability in South Africa: an analysis of General Household Survey data. Disabil Rehabil 2024:1-9. [PMID: 39140161 DOI: 10.1080/09638288.2024.2388264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/26/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE We investigated the relationship between disability and food security in South Africa using data from the General Household Survey (GHS). MATERIALS AND METHODS Regression models were utilised with GHS data (2014-2018) to gauge the likelihood of food insecurity (the dependent variable) among individuals with disabilities. Socioeconomic and demographic traits of the 2018 GHS sample were analysed. All estimates were weighted and represented nationally at the individual level. RESULTS In this study population (32 187) of food insecure people, 9.64% are disabled. Food insecurity impacts more Black people with disabilities (91%) versus those without disabilities (90%), and disabled women (65%) versus nondisabled women (58%). Most reside in KwaZulu-Natal. Those with disability grants lower food insecurity odds, while child support grant recipients face higher odds. Household size and education are significant predictors, while marital status and gender are not. CONCLUSION This study data justifies the need for disability-inclusive food security programmes in South Africa, especially amid crises like COVID-19. Significantly, there is a nil data finding about people with eating/swallowing disabilities whose needs intersect with food security. This emphasises the need for inclusive data collection that operates within a food sovereignty framework to increase the visibility of people with disabilities.
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Affiliation(s)
- Mershen Pillay
- Disciplines of Audiology and Speech-Language Pathology, School of Health Sciences, University of KwaZulu-Natal, Durban, KZN, South Africa
- Speech and Language Therapy, Institute of Education, Massey University, Auckland, New Zealand
| | - Reesha Kara
- Institute of Social and Economic Research, Rhodes University, South Africa
| | | | - Razia Motala
- Specialist Speech Language Pathologist, Sidra Medicine, Doha, Qatar
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Agurs-Collins T, Alvidrez J, ElShourbagy Ferreira S, Evans M, Gibbs K, Kowtha B, Pratt C, Reedy J, Shams-White M, Brown AG. Perspective: Nutrition Health Disparities Framework: A Model to Advance Health Equity. Adv Nutr 2024; 15:100194. [PMID: 38616067 PMCID: PMC11031378 DOI: 10.1016/j.advnut.2024.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 04/16/2024] Open
Abstract
Disparities in nutrition, such as poor diet quality and inadequate nutrient intake, arise from multiple factors and are related to adverse health outcomes such as obesity, diabetes, cardiovascular disease, and some cancers. The aim of the current perspective is to present a nutrition-centric socioecological framework that delineates determinants and factors that contribute to diet and nutrition-related disparities among disadvantaged populations. The Nutrition Health Disparities Framework (NHDF) describes the domains (biological, behavioral, physical/built environment, sociocultural environment, and healthcare system) that influence nutrition-related health disparities through the lens of each level of influence (that is, individual, interpersonal, community, and societal). On the basis of the scientific literature, the authors engaged in consensus decision making in selecting nutrition-related determinants of health within each domain and socioecological level when creating the NHDF. The framework identifies how neighborhood food availability and access (individual/built environment) intersect with cultural norms and practices (interpersonal/sociocultural environment) to influence dietary behaviors, exposures, and risk of diet-related diseases. In addition, the NHDF shows how factors such as genetic predisposition (individual/biology), family dietary practices (interpersonal/behavioral), and food marketing policies (societal) may impact the consumption of unhealthy foods and beverages and increase chronic disease risk. Family and peer norms (interpersonal/behavior) related to breastfeeding and early childhood nutrition interact with resource-poor environments such as lack of access to preventive healthcare settings (societal/healthcare system) and low usage of federal nutrition programs (societal/behavioral), which may increase risk of poor nutrition during childhood and food insecurity. The NHDF describes the synergistic interrelationships among factors at different levels of the socioecological model that influence nutrition-related outcomes and exacerbate health disparities. The framework is a useful resource for nutrition researchers, practitioners, food industry leaders, and policymakers interested in improving diet-related health outcomes and promoting health equity in diverse populations.
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Affiliation(s)
- Tanya Agurs-Collins
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States.
| | | | - Sanae ElShourbagy Ferreira
- National Center for Advancing Translational Sciences, Division of Clinical Innovation, Bethesda, MD, United States
| | - Mary Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, Division of Digestive Diseases and Nutrition, Bethesda, MD, United States
| | - Kimberlea Gibbs
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Extramural Research, Pediatric Growth and Nutrition Branch, Bethesda, MD, United States
| | | | - Charlotte Pratt
- National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States
| | - Jill Reedy
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Marissa Shams-White
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Alison Gm Brown
- National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States
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Berkowitz SA, Seligman HK, Palakshappa D. Understanding food insecurity risk in the United States: A longitudinal analysis. SSM Popul Health 2024; 25:101569. [PMID: 38156292 PMCID: PMC10753081 DOI: 10.1016/j.ssmph.2023.101569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 12/30/2023] Open
Abstract
Background Food insecurity, lack of consistent access to the food needed for an active, healthy life, harms population health. Although substantial biomedical evidence examines the connections between food insecurity and health, fewer studies examine why food insecurity occurs. Methods We propose a conceptual understanding of food insecurity risk based on institutions that distribute income-the factor payment system (income distribution stemming from paid labor and asset ownership), transfers within households, and the government tax-and-transfer system. A key feature of our understanding is 'roles' individuals inhabit in relation to the factor payment system: child, older adult, disabled working-age adult, student, unemployed individual, caregiver, or paid laborer. A second feature is that the roles of others in an individual's household also affect an individual's food insecurity risk. We tested hypotheses implied by this understanding, particularly hypotheses relating to role, household composition, and income support programs, using nationally-representative, longitudinal U.S. Current Population Survey data (2016-2019). Results There were 16,884 participants (year 1 food insecurity prevalence: 10.0%). Inhabiting roles of child (Relative Risk [RR] 1.79, 95% Confidence Interval [95%CI] 1.67 to 1.93), disabled working age-adult (RR 3.74, 95%CI 3.25 to 4.31), or unemployed individual (RR 3.29, 95%CI 2.51 to 4.33) were associated with a greater risk of food insecurity than being a paid laborer. Most food insecure households, 74.8%, had members inhabiting roles of child or disabled working age-adult, and/or contained individuals who experienced job loss. Similar associations held when examining those transitioning from food insecurity to food security in year 2. Conclusions The proposed understanding accords with the pattern of food insecurity risk observed in the U.S. An implication is that transfer income programs for individuals inhabiting roles, such as childhood and disability, that limit factor payment system participation may reduce food insecurity risk for both those individuals and those in their household.
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Affiliation(s)
- Seth A. Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hilary K. Seligman
- University of California San Francisco, Division of General Internal Medicine, San Francisco, CA, USA
- Center for Vulnerable Populations at San Francisco General Hospital & Trauma Center, San Francisco, CA, USA
| | - Deepak Palakshappa
- Section of General Internal Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Section of General Pediatrics, Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Hadfield-Spoor M, Avendano M, Loopstra R. Food insecurity and disability among working-age and older adults. Public Health Nutr 2024; 27:e84. [PMID: 38404256 DOI: 10.1017/s1368980024000570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To explore relationships between disability, food insecurity (FI) and age and examine how socio-economic factors impact risk of FI among disabled people in working and older age. DESIGN Logistic regression models used to analyse the contribution of socio-economic factors to gaps in risk of FI for disabled people. In models stratified into working and older age groups, differences in risk of FI for disabled and non-disabled people were examined by employment, education and assets. SETTING England, Wales and Northern Ireland, 2016 and 2018. PARTICIPANTS A representative sample of 6187 adults aged 16+, of whom 28 % were disabled, from the Food & You survey. RESULTS The gap in FI risk by disability status decreased as age increased. For ages 25-34 for disabled v. non-disabled people, risk of FI was 31 % (95 % CI 21-41 %) v. 10 % (8-12 %); at ages 45 to 54, it was 18 % (11-23 %) v. 7 % (5-8 %), and at ages 75+, there was no gap in risk. Accounting for socio-economic variables halved the gap in risk among working ages. However, among working-age adults, FI among disabled people in full-time work was 15 % (11-20 %) compared with only 7 % (6-9 %) among non-disabled people in full-time work. Among older people, disabled people without savings were at higher risk of FI (5 % (3-7 %)) than non-disabled people without savings (2 % (1-3 %)) but having savings closed risk gap. CONCLUSIONS Socio-economic resources partially explain disparities in FI risk when disabled. Disparities remained for people in full-time work and among people without savings in older age.
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Affiliation(s)
- Mia Hadfield-Spoor
- Department of Nutritional Sciences, Franklin Wilkins Building, King's College London, 150 Stamford Street, London, UK
| | - Mauricio Avendano
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisante), University of Lausanne, Lausanne, Switzerland
| | - Rachel Loopstra
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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Twardzik E, Schrack JA, Pollack Porter KM, Coleman T, Washington K, Swenor BK. TRansit ACessibility Tool (TRACT): Developing a novel scoring system for public transportation system accessibility. JOURNAL OF TRANSPORT & HEALTH 2024; 34:101742. [PMID: 38405233 PMCID: PMC10883474 DOI: 10.1016/j.jth.2023.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Introduction Although federal laws require equal access to public transportation for people with disabilities, access barriers persist. Lack of sharing accessibility information on public transportation websites restricts people with disabilities from making transportation plans and effectively using public transportation systems. This project aims to document information provided about public transportation systems accessibility and share this information using an open data platform. Methods We reviewed the top twenty-six public transportation systems in the United States based on federal funding in fiscal year 2020. Information about accessibility was abstracted from each public transportation system website by two independent reviewers from February-March 2022. Informed by universal design principles, public transportation systems were scored across six dimensions: facility accessibility (0-22 points), vehicle accessibility (0-11 points), inclusive policies (0-12 points), rider accommodations (0-9 points), paratransit services (0-6 points), and website accessibility (0-2 points). Total scores were calculated as the sum of each dimension (0-62 points). Data and findings were publicly disseminated (https://disabilityhealth.jhu.edu/transitdashboard/). Results The average overall accessibility information score was 31.9 (SD=6.2) out of 62 possible points. Mean scores were 8.4 (SD=2.9) for facility accessibility, 4.5 (SD=2.1) for vehicle accessibility, 7.8 (SD=1.6) for inclusive policies, 4.9 (SD=1.6) for rider accommodations, 4.5 (SD=2.0) for paratransit services, and 1.8 (SD=0.4) for website accessibility. Eleven public transportation systems (42%) received the maximum score for paratransit services and 20 (77%) received the maximum score for website accessibility. No public transportation system received the maximum score for any of the other dimensions. Conclusions Using a novel scoring system, we found significant variation in the accessibility information presented on public transportation system websites. Websites are a primary mode where users obtain objective information about public transportation systems and are therefore important platforms for communication. Absence of accessibility information creates barriers for the disability community and restricts equal access to public transportation.
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Affiliation(s)
- Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Keshia M. Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Taylor Coleman
- The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA
| | - Kathryn Washington
- The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA
| | - Bonnielin K. Swenor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Saif NT, Addison OR, Hughes Barry K, Falvey JR, Parker EA. Associations between social isolation and diet quality among US adults with disability participating in the National Health and Nutrition Examination Survey, 2013-2018. Prev Med Rep 2023; 36:102413. [PMID: 37753381 PMCID: PMC10518724 DOI: 10.1016/j.pmedr.2023.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
Social isolation and disability are established risk factors for poor nutrition. We aimed to assess whether social isolation is associated with diet quality specifically among adults with disabilities. This cross-sectional analysis used data from the National Health and Nutrition Examination Survey, 2013-2018. Adults with a disability, who were not pregnant, breastfeeding, or missing dietary intake data were included (n = 5,167). Disability was defined as a physical functioning limitation based on difficulty with any activities of daily living, instrumental activities of daily living, lower extremity mobility activities, or general physical activities. The Healthy Eating Index (HEI)-2015 measured diet quality; higher scores correspond to higher diet quality. We computed a social isolation index by summing single status, living alone, and two social engagement difficulty measures (one point for each component met; maximum 4 points). Multivariable linear regression, controlling for demographic and health covariates, estimated differences in HEI scores for dietary intake data, by social isolation score. Over half of HEI scores were < 51, corresponding to "poor" diet quality. Higher social isolation score was associated with lower vegetable and seafood/plant proteins intake. Single status and one of two social engagement measures were associated with lower scores on certain adequacy components. Differences were modest. There was little evidence of effect modification by age or gender. Adults with disabilities are not meeting national dietary standards; improving diet quality is a priority. Whether social isolation is associated with specific dietary components in this population requires further investigation. Further research is also needed among younger adults.
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Affiliation(s)
- Nadia T. Saif
- Department of Epidemiology and Public Health at the University of Maryland School of Medicine, Baltimore, MD, United States
| | - Odessa R. Addison
- Department of Physical Therapy and Rehabilitative Science, University of Maryland School of Medicine, Baltimore, MD, United States
- Baltimore VA Medical Center Geriatric Research Education and Clinical Center (GRECC), VA Maryland Health Care System, Baltimore, United States
| | - Kathryn Hughes Barry
- Department of Epidemiology and Public Health at the University of Maryland School of Medicine, Baltimore, MD, United States
- Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, United States
| | - Jason R. Falvey
- Department of Epidemiology and Public Health at the University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Physical Therapy and Rehabilitative Science, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Elizabeth A. Parker
- Department of Physical Therapy and Rehabilitative Science, University of Maryland School of Medicine, Baltimore, MD, United States
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Gatton ML, Gallegos D. A 5-year review of prevalence, temporal trends and characteristics of individuals experiencing moderate and severe food insecurity in 34 high income countries. BMC Public Health 2023; 23:2215. [PMID: 37946172 PMCID: PMC10636923 DOI: 10.1186/s12889-023-17139-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Due to the relatively low numbers of households in high income countries experiencing food insecurity most studies conflate the levels of severity, which masks between- and within-country differences. This study aims to describe the characteristics of individuals living in high income countries who were moderately or severely food insecure and investigates temporal trends in prevalence. It assesses these characteristics in comparison to those who were food secure. METHODS This is a secondary analysis of data collected by the FAO Voices of the Hungry between 2014-2018. The data were collected during the annual Gallup World Polls of nationally representative samples using the Food Insecurity Experience Scale. Data from 34 highly developed, wealthy countries were analysed. The age, gender, income, education, area of residence and household structure of individuals experiencing moderate/severe food insecurity (FI), and severe FI, were compared using ANOVA, Welch's F, Pearson's Chi-square, and Linear-by-Linear Association, dependent on the variable of interest. Hierarchical cluster analysis was used to group countries according to their prevalence of moderate/severe FI, and severe FI. RESULTS Overall, 6.5% of the weighted sample were moderately/severely food insecure (M-SFI), while 1.6% were severely food insecure. M-SFI individuals were present in all 34 countries, in all years and across all education levels and income quintiles. The proportion of individuals experiencing moderate/severe FI varied between years and countries. Fifteen countries showed a significant downward temporal trend in prevalence of moderate/severe FI (p < 0.001), while three countries demonstrated an increasing temporal trend driven by increasing prevalence in those aged 65 years or less (p < 0.001). Comparing individuals experiencing moderate versus severe FI showed over-representation of males, single adult households and lower household income in the severe FI group. CONCLUSIONS Individuals across all income, education and age categories living in high income countries are experiencing moderate/severe food insecurity, but with higher prevalence in those experiencing more disadvantage. Over the study period some countries experienced escalating while others demonstrated decreasing moderate/severe FI trends. This comparison of countries with similar economic and human development indices highlights an opportunity to investigate subtle variations in social, economic and education policy that could have profound impacts on food insecurity.
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Affiliation(s)
- Michelle L Gatton
- Centre for Immunology and Infection Control, Faculty of Health, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia.
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), Graham St, South Brisbane, QLD, 4101, Australia
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Deierlein AL, Litvak J, Liu C, Stein CR. Diet quality, diet-related factors and disability status among male adults of reproductive age in the USA. Public Health Nutr 2023; 26:1976-1985. [PMID: 37395178 PMCID: PMC10564594 DOI: 10.1017/s1368980023001222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 05/19/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To examine diet quality and diet-related factors among male adults of reproductive age with and without disabilities. DESIGN Cross-sectional data from the National Health and Nutrition Examination Surveys, 2013-2018. SETTING Disability was reported as serious difficulty hearing, seeing, concentrating, walking, dressing and/or running errands due to physical, mental or emotional conditions. Diet quality was assessed by the Healthy Eating Index (HEI)-2015 and diet-related factors included self-rated diet healthfulness, food security and food assistance programmes. Multivariable linear regression estimated differences in HEI-2015 scores. Multivariable Poisson regression estimated adjusted prevalence ratios (aPR) and 95 % CI for diet-related factors. PARTICIPANTS In total, 3249 males, 18-44 years; of whom, 441 (13·4 %) reported having disabilities. RESULTS Compared with males without disabilities, those with disabilities had a 2·69-point (95 % CI: -4·18, -1·20) lower mean total HEI-2015 score and approximately one-third to half of a point lower HEI-2015 component scores for greens and beans, total protein foods, seafood and plant proteins, fatty acids and added sugars. Males with any disabilities were more likely to have low food security (aPR = 1·57; 95 % CI: 1·28, 2·92); household participation in food assistance programmes (aPR = 1·61; 95 % CI: 1·34, 1·93) and consume fast food meals during the previous week (1-3 meals: aPR = 1·11; 95 % CI: 1·01-1·21 and 4 or more meals: aPR = 1·18; 95 % CI: 1·01-1·38) compared with males with no disabilities. CONCLUSIONS Factors affecting diet and other modifiable health behaviours among male adults of reproductive age with disabilities require further investigation. Health promotion strategies that are adaptive to diverse populations within the disability community are needed.
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Affiliation(s)
| | - Jaqueline Litvak
- School of Global Public Health, New York University, New York, NY, USA
| | - Chang Liu
- School of Global Public Health, New York University, New York, NY, USA
| | - Cheryl R Stein
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
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Anderson E, McCurley JL, Sonnenblick R, McGovern S, Fung V, Levy DE, Clark CR, Thorndike AN. Food Insecurity and Diet Quality Among Adults on Medicaid With and Without a Mental Illness Diagnosis. J Acad Nutr Diet 2023; 123:1470-1478.e2. [PMID: 37207956 PMCID: PMC10524583 DOI: 10.1016/j.jand.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/07/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Adults with mental illnesses are more likely to have low income and diet-related chronic diseases. OBJECTIVE This study examined associations of mental illness diagnosis status with food insecurity and diet quality and whether the relationship between food security status and diet quality differed by mental illness diagnosis status in adult Medicaid beneficiaries. DESIGN This was a secondary cross-sectional analysis of baseline (2019-2020) data collected as part of the LiveWell study, a longitudinal study evaluating a Medicaid food and housing program. PARTICIPANTS/SETTING Participants were 846 adult Medicaid beneficiaries from an eastern Massachusetts health system. MAIN OUTCOME MEASURES Food security was measured with the 10-item US Adult Food Security survey module (0 = high food security, 1-2 = marginal food security, 3-10 = low/very low food security). Mental illness diagnoses included health record-documented anxiety, depression, or serious mental illness (eg, schizophrenia, bipolar disorder). Healthy Eating Index (HEI-2015) scores were calculated from 24-hour dietary recalls. STATISTICAL ANALYSES Multivariable regression analyses adjusted for demographics, income, and survey date. RESULTS Participants' mean (standard deviation) age was 43.1 (11.3) years, and 75% were female, 54% Hispanic, 33% non-Hispanic White, and 9% non-Hispanic Black. Fewer than half (43%) of participants reported high food security, with almost one third (32%) reporting low or very low food security. The 341 (40%) participants with one or more mental illness diagnosis had greater odds of low/very low food security (adjusted odds ratio [OR], 1.94; 95% confidence interval [CI], 1.38-2.70) and had similar mean HEI-2015 scores (53.1 vs 56.0; P = 0.12) compared with participants with no mental illness diagnosis. Mean adjusted HEI-2015 scores did not significantly differ by high vs low/very low food security for those without a mental illness diagnosis (57.9 vs 54.9; P = 0.052) or those with a mental illness diagnosis (53.0 vs 52.9; P = 0.99). CONCLUSION In a cohort of adults with Medicaid, those with mental illness diagnoses had higher odds of experiencing food insecurity. Overall, diet quality among adults in this sample was low but did not differ by mental illness diagnosis or food security status. These results highlight the importance of augmenting efforts to improve both food security and diet quality among all Medicaid participants.
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Baxter SLK, Koob CE, Hossfeld CML, Griffin SF, Mobley C, Hossfeld LH. Food Insecurity, the Food Environment, and COVID-19 in Rural South Carolina. FAMILY & COMMUNITY HEALTH 2023; 46:128-135. [PMID: 36799946 PMCID: PMC9930688 DOI: 10.1097/fch.0000000000000355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In this study, we explored the relationship between the food environment and food security among rural adults during the COVID-19 pandemic. Researchers, with assistance from community partners, conducted a cross-sectional survey assessing the impact of COVID-19 on food access, food security, and physical activity in 9 rural South Carolina (SC) counties. This survey was administered to a purposive sample (N = 587) from August 2020 to March 2021. The dependent variable was a binary indicator of food insecurity (past 3 months), in accordance with the USDA Household Food Security Survey Module. Independent variables were sociodemographic characteristics, food environment factors (eg, shopping at grocery stores, partial markets, and farmers' markets), and shopping behaviors during the pandemic. Overall, 31% of respondents were food insecure. Food security status differed by income and household composition. Results indicate that the odds of food insecurity were higher for respondents who shopped frequently at partial markets (adjusted odds ratio [AOR] = 1.61, 95% confidence interval [CI]: 1.01-2.56) and shopped more for food before the pandemic than during the pandemic (AOR = 1.68, 95% CI: 1.07-2.64). Findings underscore the importance of examining the relationship between the food environment and food insecurity during COVID-19 in rural settings.
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Affiliation(s)
- Samuel L. K. Baxter
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Caitlin E. Koob
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Cassius M. L. Hossfeld
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Sarah F. Griffin
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Catherine Mobley
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Leslie H. Hossfeld
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
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Hernández-Vásquez A, Bartra Reátegui A, Sánchez-Dávila K, Vargas-Fernández R. Association between Disability and Unmet Food Needs in the Venezuelan Migrant and Refugee Population: Analysis of a Population-Based Survey, 2022. Nutrients 2023; 15:nu15071663. [PMID: 37049502 PMCID: PMC10097386 DOI: 10.3390/nu15071663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
In Peru, Venezuelan migrants and refugees have been exposed to food shortages before their emigration. This problem could have worse outcomes in vulnerable populations (such as people with disabilities); however, the literature on the basic needs of this population is still scarce. The objective was to determine the association between the presence of disability and the unmet need for access to food in the household of the Venezuelan migrant and refugee population residing in Peru. A cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru (ENPOVE 2022). The outcome variable was unmet need for food, while the independent variable was the presence of disability. Poisson log generalized linear regression models (crude and adjusted for potential confounding variables) were fitted to evaluate the association between the variables of interest, reporting prevalence ratios (PR) and 95% confidence intervals (CIs). A total of 7739 migrants and refugees from Venezuela were included. The proportion of unmet need for access to food in the household was 45.2%, while the proportion of disability was 2.1%. People with disabilities were found to be more likely to have an unmet need for access to food at home (adjusted PR [aPR]: 1.25; 95% CI: 1.08–1.46; p = 0.003). According to our findings, almost half of Venezuelan households were found to have an unmet need for access to food. In addition, Venezuelan migrants and refugees with disabilities were more likely to have an unmet need for this basic need.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15046, Peru
- Correspondence:
| | - Alicia Bartra Reátegui
- Vicerrectorado de Investigación, Universidad Nacional de San Martín, Tarapoto 22201, Peru; (A.B.R.); (K.S.-D.)
| | - Keller Sánchez-Dávila
- Vicerrectorado de Investigación, Universidad Nacional de San Martín, Tarapoto 22201, Peru; (A.B.R.); (K.S.-D.)
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Sassine AJ, Rabbitt MP, Coleman-Jensen A, Moshfegh AJ, Sahyoun NR. Development and Validation of a Physical Food Security Tool for Older Adults. J Nutr 2023; 153:1273-1282. [PMID: 36868513 DOI: 10.1016/j.tjnut.2023.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Current measures of food insecurity focus on economic access to food, but not on the physical aspect of food insecurity that captures the inability to access food or prepare meals. This is particularly relevant among the older adult population who are at a high risk of functional impairments. OBJECTIVES To develop a short-form physical food security (PFS) tool among older adults using statistical methods based on the Item Response Theory (Rasch) model. METHODS Pooled data from adults aged ≥60 y of the NHANES (2013-2018) (n = 5892) were used. The PFS tool was derived from the physical limitation questions included in the physical functioning questionnaire of NHANES. Item severity parameters, fit and reliability statistics, and residual correlation between items were estimated using the Rasch model. The construct validity of the tool was assessed by examining associations with the Healthy Eating Index (HEI)-2015 scores, self-reported health, self-reported diet quality, and economic food insecurity, using weighted multivariable linear regression analysis, controlling for potential confounders. RESULTS A 6-item scale was developed, which had adequate fit statistics and high reliability (0.62). It was categorized based on raw score severity into high, marginal, low, and very low PFS. Very low PFS was associated with respondent's self-reported poor health (OR = 23.8; 95% CI: 15.3, 36.9; P < 0.0001), self-reported poor diet (OR = 3.9; 95% CI: 2.8, 5.5; P < 0.0001), low and very low economic food security (OR = 6.08; 95% CI: 4.23, 8.76; P < 0.0001), and with lower mean HEI-2015 index score, in comparison to older adults with high PFS (54.5 compared with 57.5, P = 0.022). CONCLUSIONS The proposed 6-item PFS scale captures a new dimension of food insecurity that can inform on how older adults experience food insecurity. The tool will require further testing and evaluation in larger and different contexts to demonstrate its external validity.
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Affiliation(s)
- AnnieBelle J Sassine
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States
| | | | | | - Alanna J Moshfegh
- Beltsville Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States.
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Bagni UV, Abreu Rodrigues AVD, Ribeiro ECDS, Salles-Costa R, Ferreira AA. Food insecurity in households with persons with disabilities in a situation of extreme vulnerability in Brazil: a secondary cross-sectional analysis. LANCET REGIONAL HEALTH. AMERICAS 2023; 18:100417. [PMID: 36844017 PMCID: PMC9950656 DOI: 10.1016/j.lana.2022.100417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 10/15/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
Background Inequities in access to education, work and health care are striking among persons with disabilities, making this population more vulnerable to poverty, lack of access to basic services and violation of rights such as access to food. Household food insecurity (HFI), marked by precarious income, has increased among persons with disabilities. In Brazil, the Continuous Cash Benefit (In Portuguese, Benefício de Prestação Continuada - BPC) is the guarantee of a minimum wage for persons with disabilities as a measure to promote social security and access to income in a situation of extreme poverty. Thus, the objective of this study was to assess HFI among persons with disabilities in extreme poverty in Brazil. Methods A cross-sectional study with national representation was carried out with data from the 2017/2018 Family Budget Survey, with moderate and severe food insecurity as the dependent variable, and the situation of food insecurity measured using the Brazilian Food Insecurity Scale. Prevalence and odds ratio estimates were generated with 99% confidence intervals. Findings Approximately 25% of households experienced HFI, with a higher prevalence in the North Region (41%), receiving up to 1 income quintile (36.6%), with a female (26.2%) and black person (31%) as a reference. The analysis model found that region, per capita household income, and social benefits received in the household were statistically significant factors. Interpretation The BPC proved to be an important source of household income for persons with disabilities living in extreme poverty in Brazil: in almost three-quarters of the households, it was the only social benefit received, and, for most of them, it represented more than half of the total household income. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Affiliation(s)
- Ursula Viana Bagni
- Department of Social Nutrition, Emília de Jesus Ferreira College of Nutrition, Federal Fluminense University, Niterói, RJ, Brazil
| | - Alexia Vieira de Abreu Rodrigues
- Postgraduate Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Eloah Costa de Sant’Anna Ribeiro
- Postgraduate Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rosana Salles-Costa
- Postgraduate Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Social and Applied Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Alves Ferreira
- Postgraduate Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Social and Applied Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Dietary Quality and Diet-Related Factors Among Female Adults of Reproductive Age With and Without Disabilities Participating in the National Health and Nutrition Examination Surveys, 2013-2018. J Acad Nutr Diet 2023; 123:263-275. [PMID: 35872244 DOI: 10.1016/j.jand.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Female adults of reproductive age (18 to 44 years) with disabilities have higher rates of health-risk behaviors and chronic conditions compared with their counterparts without disabilities; however, there is limited examination of diet. OBJECTIVE Our aim was to examine associations of self-reported disability status with diet quality and diet-related factors. DESIGN Cross-sectional data were from the National Health and Nutrition Examination Surveys, 2013-2018. PARTICIPANTS/SETTING Female adults aged 18 through 44 years were included. Disability was defined as serious difficulty hearing, seeing, concentrating, walking, dressing, and/or running errands due to physical, mental, or emotional conditions. MAIN OUTCOME MEASURES The Healthy Eating Index-2015 assessed diet quality. Diet-related factors included self-rated diet healthfulness, meal characteristics, food security, and food assistance programs. STATISTICAL ANALYSIS Multivariable linear regression estimated differences in Healthy Eating Index-2015 scores for a given day and multivariable Poisson regression estimated adjusted prevalence ratios and 95% CI of diet-related factors by disability status. RESULTS Of 3,579 female adults, 557 (16%) reported any disabilities, 207 (6%) of whom reported having 2 or more types of disabilities. Differences in mean Healthy Eating Index-2015 scores for a given day were one-third to one-half a point lower for fruits, total protein foods, and seafood and plant proteins among female adults with 2 or more types of disabilities compared with those without disabilities. Female adults with any disabilities were more likely to rate their diet as poor, have low food security, participate in food-assistance programs, and consume frozen foods or pizza, compared with those without disabilities (adjusted prevalence ratio ranged from 1.35 to 1.93); they were less likely to be the main food planner or preparer or shopper for their households. CONCLUSIONS Some indicators of diet quality and diet-related factors differed between female adults with and without disabilities. Additional investigation of dietary intakes and behaviors, as well as access to and availability of healthy foods, among female adults with disabilities is necessary.
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Agripreneurship as a panacea for food security in Tanzania: A systematic review. Heliyon 2023; 9:e13305. [PMID: 36816280 PMCID: PMC9932438 DOI: 10.1016/j.heliyon.2023.e13305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Agripreneurship as one of the means to ensure food security in Tanzania has received scant attention. This study bridges the knowledge gap by showing the state of the art on agripreneurship and food security in Tanzania, research themes and new developments on the two concepts, showing literature gaps and practise on the concepts, and showing how agripreneurship is a solution to food insecurity in Tanzania. Herein, a total of 61 articles retrieved from Scopus, Google Scholar, and the Web of Science databases on the themes of agripreneurship and food security were reviewed. This study has demonstrated agripreneurship techniques can be a solution to food security by ensuring food availability, accessibility, and affordability. Thus, it is recommended to the policymakers that they formulate a policy that focuses on both supply-side and demand-side factors. Furthermore, agripreneurs are urged to update their knowledge and skills so that they can access timely information through ICT tools, mostly TV, radio, and phone.
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Codner A, Zack RM, Liu X, Bangham C, Nelson E, Hicks JM, Greece JA. Socio-demographic factors associated with hunger among food pantry users in Eastern Massachusetts. J Nutr Sci 2023; 12:e53. [PMID: 37180481 PMCID: PMC10173085 DOI: 10.1017/jns.2022.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 05/16/2023] Open
Abstract
To assess the determinants of hunger among food pantry users, the present study used a cross-sectional survey that included a modified Household Hunger Scale to quantify hunger. Mixed-effects logistic regression models were used to assess the relationship between hunger categories and various household socio-demographic and economic characteristics, such as age, race, household size, marital status and experience of any economic hardship. The survey was administered to food pantry users from June 2018 to August 2018 at various food pantries across Eastern Massachusetts with 611 food pantry users completing the questionnaire at any of the 10 food pantry sites. One-fifth (20⋅13 %) of food pantry users experienced moderate hunger and 19⋅14 % experienced severe hunger. Food pantry users who were single, divorced or separated; had less than a high school education; working part-time, unemployed or retired; or, who earned incomes less than $1000 per month were most likely to experience severe or moderate hunger. Pantry users who experienced any economic hardship had 4⋅78 the adjusted odds of severe hunger (95 % CI 2⋅49, 9⋅19), which was much larger than the odds of moderate hunger (AOR 1⋅95; 95 % CI 1⋅10, 3⋅48). Younger age and participation in WIC (AOR 0⋅20; 95 % CI 0⋅05-0⋅78) and SNAP (AOR 0⋅53; 95 % CI 0⋅32-0⋅88) were protective against severe hunger. The present study illustrates factors affecting hunger in food pantry users, which can help inform public health programmes and policies for people in need of additional resources. This is essential particularly in times of increasing economic hardships recently exacerbated by the COVID-19 pandemic.
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Affiliation(s)
- Alyson Codner
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Rachel M. Zack
- Greater Boston Food Bank, 70 S Bay Ave, Boston, MA 02118, USA
| | - Xinyang Liu
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Candice Bangham
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Eva Nelson
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Jacqueline Milton Hicks
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118, USA
| | - Jacey A. Greece
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
- Corresponding author: Jacey A. Greece, email
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Murgoci N. The impact of perception regarding therapeutic exercises and dietary changing adherence of subjects known with low back pain. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract: Debates regarding the role of therapeutic exercises and diet as modulators of an anti-inflammatory state occurred in the last years in the medical environment. The syner-gy between moderate-intensity exercise and a proper diet targeting decreasing IL-1 inhib-its the production of the pro-inflammatory cytokine TNF-α, the key regulator of local and systemic inflammation. One of the most important causes of short and long-term disabil-ity in all occupational groups is back pain, impacting the quality of life. Degeneration of the intervertebral disc (IVD) causes low back pain that intensifies with age. Assessment of the Oswestry Disability Index was applied on 23 subjects with low back pain to investigate the degree of disability. Nutrition of IVD, implying therapeutic exercises, and a customized diet may be crucial adjuvants for the rehabilitation process. The appropriate diet and therapeutic exercise approach are meant to evaluate the impact of awareness regarding the possibility of improving health outcomes. In this present study, women have a strong positive Pearson correlation (p<0.05) with minimal (66-70 years) disability and moderate disability (r=1.000, CI =99%). Subjects with moderate disability conditions have “no” intention to implement diet changes and maintain therapeutic exercise adher-ence (r=0.902, CI = 95%). Men (71-75 years, r=0.995, CI =99%) registered a positive strong correlation with maximum deficiency (r=1.000, CI =99%) and “possible no” change in diet and exercise adherence will be applied (r=0.866, CI = 95%). Total disability responders an-swered with a “probable yes” option (r=0.884, CI=95%) but the dependence on their ca-reers is decisive. The education strategy is essential because diet change implementation can cause resistive behavior as well as adherence to exercise therapy. A key to effectively managing the inflammatory state due to different comorbidities is to use the cumulative effects of health professionals' prescriptions. The challenge is to ensure adherence to these actions for each patient.
Keywords: anti-inflammatory, therapeutic exercises, rehabilitation, diet, Oswestry Disability In-dex (ODI), back pain, intervertebral disc, nutrition, perception, disability.
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Affiliation(s)
- Nicolae Murgoci
- 1 “Dunărea de Jos” University, Faculty of Physical Education and Sports, Department of Individual Sports and Kinetotherapy, 63-65 Gării Street, Galați, Romania
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The Interactions of Food Security, Health, and Loneliness among Rural Older Adults before and after the Onset of COVID-19. Nutrients 2022; 14:nu14235076. [PMID: 36501106 PMCID: PMC9739434 DOI: 10.3390/nu14235076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
Older adults and those living in rural areas face unique challenges to health and food security which were exacerbated during the COVID-19 pandemic. We examine the interrelationships among food security, physical health, and loneliness among rural older adults before the onset of and during the COVID-19 pandemic. Using data from a cross-sectional household survey of older adults in rural Indiana, administered May 2020 through July 2020, our results show a higher prevalence of food insecurity, poorer physical health, and increased loneliness after the onset of the pandemic. Path analyses confirmed the interrelationship between food security, health, and the absence of loneliness before and after the onset of COVID-19. Loneliness emerged as a major pathway through which the pandemic impacted quality of life, particularly affecting older women and physical health. Policy initiatives should consider the unique experiences and challenges associated with rural life among older adults and create food security initiatives that incorporate socialization while also considering the challenges associated with poor physical health in older age. Furthermore, our analysis shows that those who are vulnerable to food security, poor health, and loneliness in the absence of a global pandemic remain vulnerable during a pandemic.
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Shircliff JE, Hammon J, Linares C, Larsen T, Marquez-Velarde G. Economic Inequality during Covid-19 as a Pathway to Food Insecurity for People who are Disabled and Racialized as Non-White. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2133982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jesse E. Shircliff
- Department of Sociology and Anthropology, Utah State University, Logan, Utah, USA
| | - Jordan Hammon
- Department of Sociology and Anthropology, Utah State University, Logan, Utah, USA
| | - Carina Linares
- Department of Sociology and Anthropology, Utah State University, Logan, Utah, USA
| | - Teresa Larsen
- Department of Sociology and Anthropology, Utah State University, Logan, Utah, USA
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23
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Friedman C. Financial hardship experienced by people with disabilities during the COVID-19 pandemic. Disabil Health J 2022; 15:101359. [PMID: 35835660 PMCID: PMC9220755 DOI: 10.1016/j.dhjo.2022.101359] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/27/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND People with disabilities are poorer and more financially insecure than nondisabled people. While people with disabilities were adversely affected by the pandemic and were more likely to experience poverty prior to the pandemic, less is known about their experiences with financial hardship during the pandemic. OBJECTIVE The aim of this study was to explore the financial hardship of people with disabilities during the COVID-19 pandemic, including differences with nondisabled people and those based on people with disabilities' sociodemographics. METHODS We analyzed Household Pulse Survey data from 52,890 adults (18+) with disabilities and 391,532 nondisabled adults using complex samples descriptive statistics and binary logistic regressions. RESULTS During the Delta and first Omicron waves of the COVID-19 pandemic, 52.0% of people with disabilities had difficulty paying usual household expenses. People with disabilities were 2.78 times more likely to experience financial hardship during the pandemic than nondisabled people. People with disabilities' most common sources of income/funds for spending needs included: regular income sources (66.7%); credit cards or loans (36.6%); money from savings or selling assets or possessions (31.5%); and borrowing from friends or family (22.0%). CONCLUSIONS A significant proportion of adults with disabilities experienced financial hardship during the COVID-19 pandemic, including at greater rates than nondisabled adults. Financial hardship can have long lasting impacts upon people with disabilities, including on their physical and mental health, well-being, and overall quality of life.
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Affiliation(s)
- Carli Friedman
- CQL | The Council on Quality and Leadership, 100 West Road, Suite 300, Towson, MD 21204, USA.
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Choi YJ, Crimmins EM, Ailshire JA. Food insecurity, food environments, and disparities in diet quality and obesity in a nationally representative sample of community-dwelling older Americans. Prev Med Rep 2022; 29:101912. [PMID: 35911578 PMCID: PMC9326331 DOI: 10.1016/j.pmedr.2022.101912] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
Food insecurity, reflecting a household's low ability to purchase healthy food, is a public health concern that is associated with poor diet and obesity. Poor food environments, characterized as a neighborhood with low access to healthy, affordable food, may amplify the negative impact of food insecurity on diet and obesity. This study aims to investigate whether food insecurity and food environments are jointly associated with an increased risk of poor diet quality and obesity. We used data from a nationally representative sample of community-dwelling older adults in the Health and Retirement Study Health Care and Nutrition Survey and the National Neighborhood Data Archive to investigate the role of household and neighborhood characteristics on diet and obesity. Weighted regression models were estimated to examine the relationship between food insecurity and food environments as well as their interaction with diet quality and obesity. Food insecure respondents had lower Healthy Eating Index scores and were more likely to be obese than food secure respondents. Living in a poor food environment was associated with lower Healthy Eating Index scores, but not with obesity. We did not find any interaction between food insecurity and food environment in determining either healthy eating or obesity. Reducing food insecurity and increasing access to healthy food environments may encourage healthier eating among older adults, while alleviating food-related hardship may also reduce their obesity risk.
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Affiliation(s)
- Yeon Jin Choi
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
| | - Eileen M. Crimmins
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
| | - Jennifer A. Ailshire
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
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25
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Green BW, Labagnara K, Macdonald E, Feiertag N, Zhu M, Gupta K, Mohan C, Watts KL, Rai A, Small AC. Evaluating the association between food insecurity and risk of nephrolithiasis: an analysis of the National Health and Nutrition Examination Survey. World J Urol 2022; 40:2641-2647. [PMID: 36125503 DOI: 10.1007/s00345-022-04150-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022] Open
Abstract
PURPOSE This study aimed to investigate the relationship between self-reported food security and kidney stone formation. METHODS Data were collected from the National Health and Nutrition Examination Survey (NHANES), a database representative of the United States population. Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Characteristics of patients were compared using the Chi-square test and the student t-test. Multivariate logistic regression was performed using a multi-model approach. RESULTS We analyzed 6,800 NHANES survey respondents. 37.2% of respondents were categorized as having "low food security" (scores 2-4) and 24.0% having "very low food security" (scores 5-6). 8.4% of respondents had a history of kidney stones. We found that people with very low food security had a 42% increased likelihood of developing kidney stones compared to those with high or marginal food security, after controlling for race, age, and comorbidities (OR 1.42; 95% CI 1.01-1.99). Between the different food security groups, no significant differences were observed in age, race/ethnicity, body mass index, gout history, osteoporosis history, or coronary artery disease history. Lower food security was associated with slightly younger age (< 1 year difference, p = 0.001), higher poverty-income ratio (p = 0.001), and many comorbidities, including kidney stones (p = 0.007). CONCLUSION Our study provides evidence for an association between food access and the risk of kidney stone disease. Given these findings, food insecurity should be investigated as a modifiable risk factor for the development of kidney stone disease.
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Affiliation(s)
- Benjamin W Green
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA
| | - Kevin Labagnara
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA
| | - Eric Macdonald
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA
| | - Nathan Feiertag
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA
| | - Michael Zhu
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA
| | - Kavita Gupta
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA
| | - Charan Mohan
- Smith Institute for Urology, Northwell Health System, New Hyde Park, NY, USA
| | - Kara L Watts
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA
| | - Arun Rai
- Smith Institute for Urology, Northwell Health System, New Hyde Park, NY, USA
| | - Alexander C Small
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA.
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Williams MR, Do DP. Income disparities in mental health: investigating the role of food insecurity by disability status. Public Health Nutr 2022; 26:1-11. [PMID: 36093676 PMCID: PMC10131146 DOI: 10.1017/s1368980022002063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 06/23/2022] [Accepted: 08/26/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate whether food insecurity helps explain the association between income and psychological distress and if its role differs by disability status. DESIGN Using 2011-2017 National Health Interview Survey cross-sectional data (n 102 543), we conducted linear regression models, fully interacted with disability status, to estimate the association between income-to-poverty ratio (IPR) (<1, 1-<2, 2-<4, ≥4) and psychological distress (Kessler 6 (K6) Scale, range: 0-24). Base models adjusted for socio-demographic factors. We then added food security (secure, low and very low), interacted with disability, and conducted post-estimation adjusted Wald tests. SETTING USA. PARTICIPANTS Nationally representative sample of non-institutionalised adults 18 years and older. RESULTS The association between income and psychological distress was stronger for people with disabilities. Compared to those in the highest income category (IPR ≥4), poor individuals (IPR < 1) with and without disabilities scored 2·10 (95 % CI (1·74, 2·46)) and 0·81 (95 % CI (0·69, 0·93)) points higher on the K6 Scale, respectively. Accounting for food insecurity reduced the estimated income disparity in psychological distress significantly more among individuals with disabilities (0·96 points or 46 %) than without disabilities (0·34 points or 42 %), decreasing the difference in the income disparity between those with and without disabilities by 48 % (0·62 points). Further, food insecurity more strongly predicted psychological distress for individuals with disabilities independent of socio-economic disadvantage. CONCLUSIONS Food insecurity plays a more important role in shaping patterns of psychological distress for people with disabilities, explaining more of the association between income and psychological distress among those with than without disabilities. Improving food security may reduce mental health disparities.
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Affiliation(s)
- Meredith R Williams
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI53201-0413, USA
| | - D Phuong Do
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI53201-0413, USA
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27
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Schwartz N, Buliung R, Daniel A, Rothman L. Disability and pedestrian road traffic injury: A scoping review. Health Place 2022; 77:102896. [PMID: 36037674 DOI: 10.1016/j.healthplace.2022.102896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022]
Abstract
Disability and ableism remain a nascent area of inquiry in road traffic injury research. A scoping review of academic literature was conducted to understand the state of knowledge on disability and pedestrian-motor vehicle collisions. Sixty-two eligible articles were identified and included. A significantly higher risk of pedestrian collisions, injuries, and fatalities was consistently found among disabled people. Risk factors included individualized factors such as walking speed and crossing decisions of disabled people. The roles of social/political environments in injury risk were less commonly explored. More research is needed to assess how inaccessible or disabling environments may produce elevated risk of pedestrian injury among disabled populations.
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Affiliation(s)
- Naomi Schwartz
- School of Occupational and Public Health, Ryerson University, 350 Victoria St, Toronto, ON, M5B 2K3, Canada.
| | - Ron Buliung
- Department of Geography and Planning, University of Toronto Mississauga, Davis Building, 1867 Inner Circle, Mississauga, ON, L5L 1C6, Canada
| | - Arslan Daniel
- Department of Geography and Planning, University of Toronto Mississauga, Davis Building, 1867 Inner Circle, Mississauga, ON, L5L 1C6, Canada
| | - Linda Rothman
- School of Occupational and Public Health, Ryerson University, 350 Victoria St, Toronto, ON, M5B 2K3, Canada; Child Health Evaluative Sciences, SickKids Research Institute, 686 Bay St, Toronto, ON, M5G 0A4, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
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28
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Shaker Y, Grineski SE, Collins TW, Flores AB. Redlining, racism and food access in US urban cores. AGRICULTURE AND HUMAN VALUES 2022; 40:101-112. [PMID: 35891801 PMCID: PMC9303837 DOI: 10.1007/s10460-022-10340-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
In the 1930s, the Home Owners' Loan Corporation (HOLC) graded the mortgage security of urban US neighborhoods. In doing so, the HOLC engaged in the practice, imbued with racism and xenophobia, of "redlining" neighborhoods deemed "hazardous" for lenders. Redlining has caused persistent social, political and economic problems for communities of color. Linkages between redlining and contemporary food access remain unexamined, even though food access is essential to well-being. To investigate this, we used a census tract-level measure of low-income and low grocery store food access from the US Department of Agriculture Food Access Research Atlas, redlining data from Mapping Inequality Project, and demographic data from the American Community Survey. We employed generalized estimating equations with robust covariance estimates to analyze data pertaining to 10,459 census tracts in 202 US cities. Tracts that the HOLC graded as "C" ("decline in desirability") and "D" ("hazardous") had reduced contemporary food access compared to those graded "A" ("best"). Increases in contemporary census tract proportions of Black, Hispanic, or other racial/ethnic minority residents, as well as disabled residents, were associated with reduced food access. Increases in contemporary proportions of residents age 75 years and older or those without a car were associated with better food access. Tracts that underwent housing redevelopment since being graded had better food access, while those undergoing gentrification had reduced food access. Results suggest that issues of redlining, housing discrimination, racism, ableism, displacement, and food inaccessibility are deeply intertwined.
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Affiliation(s)
- Yasamin Shaker
- Department of Sociology, University of Utah, 380 S 1530 E, Rm. 301, Salt Lake City, UT 84112 USA
- Center for Natural and Technological Hazards, University of Utah, 260 Central, Campus Dr., Rm. 4625, Salt Lake City, UT 84112 USA
| | - Sara E. Grineski
- Department of Sociology, University of Utah, 380 S 1530 E, Rm. 301, Salt Lake City, UT 84112 USA
- Center for Natural and Technological Hazards, University of Utah, 260 Central, Campus Dr., Rm. 4625, Salt Lake City, UT 84112 USA
| | - Timothy W. Collins
- Department of Geography, University of Utah, 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT 84112 USA
- Center for Natural and Technological Hazards, University of Utah, 260 Central, Campus Dr., Rm. 4625, Salt Lake City, UT 84112 USA
| | - Aaron B. Flores
- Center for Natural and Technological Hazards, University of Utah, 260 Central, Campus Dr., Rm. 4625, Salt Lake City, UT 84112 USA
- Department of Geographical Sciences and Urban Planning, Arizona State University, 975 S Myrtle Ave, Tempe, AZ 85287 USA
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29
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Nam HJ, Yoon JY. Factors and at-risk group associated with hypertension self-management patterns among people with physical disabilities: a latent class analysis. BMC Public Health 2022; 22:1050. [PMID: 35614420 PMCID: PMC9134671 DOI: 10.1186/s12889-022-13482-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Background People with disabilities are vulnerable to chronic diseases such as hypertension. In South Korea, over half of the population living with a physical disability suffer from hypertension. Understanding the typology of hypertension self-management patterns will assist with behavioural interventions for people with physical disabilities. Thus, this study aims to identify the typology of hypertension self-management behavioural patterns, the factors associated with the latent classes, and to recognise potential at-risk populations by comparing potential health outcomes among hypertensive adults with physical disabilities. Methods Data of 1551 participants were extracted from the 2017 National Survey of Disabled Persons. Latent classes were analysed using five indicators of self-management: smoking, alcohol consumption, physical activity, diet, and weight control. Determinants of self-management patterns, such as general characteristics, health-related factors, and social relationships, were identified using multinomial logistic regression. Further, health measures, such as health profile, psychological health, and patient experience, were compared. Results The following three latent classes were identified: “high self-management” group (40.8%), “harmful habitual behaviour” group (20.6%), and “inactive behaviour” group (38.6%). Compared with the high self-management group, the predictors of belonging to the harmful habitual behaviour group were being male, young, and single. Being female, employed, severely disabled, dependent, and unsatisfied with friendships were predictors of the inactive behaviour group. Those in the inactive behaviour group had a poor health-related quality of life, poor subjective health, depression, and unmet medical needs. Conclusions This study provides evidence that there are mutually exclusive subgroups of patients with hypertension regarding self-management patterns, identifies an array of predictive factors in each latent class membership, and distinguishes a high-risk group by comparing the health measures among patients with hypertension with physical disabilities. Analysing subgroups may assist in identifying and meeting the diverse needs of self-management support in hypertensive patients with physical disabilities.
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Affiliation(s)
- Hye Jin Nam
- College of Nursing, Seoul National University, Seoul, 03080, South Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, 03080, South Korea. .,Research Institute of Nursing Science, Seoul National University, Seoul, 03080, South Korea. .,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, 03080, South Korea.
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30
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Trani JF, Pitzer KA, Vasquez Escallon J, Bakhshi P. Access to Services from Persons with Disabilities in Afghanistan: Is Community Based Rehabilitation Making a Difference? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6341. [PMID: 35627880 PMCID: PMC9142103 DOI: 10.3390/ijerph19106341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 11/17/2022]
Abstract
The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), ratified in 2006, states that the achievement of equal rights, empowerment, and social inclusion of people with disabilities requires comprehensive rehabilitation services involving educational, social, economic, and medical interventions, all dimensions of the World Health Organization Community based rehabilitation (CBR) matrix. CBR programs aim at achieving those goals. In the present study, we investigated whether a large scale CBR program is improving access to multiple services (namely physical therapy, assistive technology, education, employment, advocacy, and community awareness) and providing satisfactions (by measuring the reduction in unmet needs) of Afghans with disabilities. We enrolled in the study 1861 newly recruited CBR participants with disabilities from 169 villages between July 2012 and December 2013, and 1132 controls screened with disabilities randomly selected with a two-stage process within 6000 households from 100 villages in the same provinces as the CBR but outside its catchment area. Using propensity score matching (PSM) and difference in difference analysis, we estimated the differences in accessing services. There were statistically significant differences between participants and controls on the access of available services between the baseline and endline. Using PSM we also found that needs were more often met among CBR participants compared to the controls. Our study indicates that a CBR program may be an effective way to provide services for persons with disabilities even in a conflict context such as Afghanistan. It contributes to addressing the longstanding question whether CBR can actually improve the rehabilitation of persons with disabilities.
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Affiliation(s)
| | - Kyle A. Pitzer
- School of Medicine, Washington University, St. Louis, MO 63130, USA;
| | | | - Parul Bakhshi
- Occupational Therapy Program, School of Medicine, Washington University, St. Louis, MO 63108, USA;
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31
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Teggart K, Ganann R, Sihota D, Moore C, Keller H, Senson C, Phillips SM, Neil-Sztramko SE. Group-based nutrition interventions to promote healthy eating and mobility in community-dwelling older adults: a systematic review. Public Health Nutr 2022; 25:1-32. [PMID: 35570675 PMCID: PMC9991860 DOI: 10.1017/s136898002200115x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 02/28/2022] [Accepted: 05/03/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify the efficacy of group-based nutrition interventions to increase healthy eating, reduce nutrition risk, improve nutritional status and improve physical mobility among community-dwelling older adults. DESIGN Systematic review. Electronic databases MEDLINE, CINAHL, EMBASE, PsycINFO and Sociological Abstracts were searched on July 15, 2020 for studies published in English since January 2010. Study selection, critical appraisal (using the Joanna Briggs Institute's tools) and data extraction were performed in duplicate by two independent reviewers. SETTING Nutrition interventions delivered to groups in community-based settings were eligible. Studies delivered in acute or long-term care settings were excluded. PARTICIPANTS Community-dwelling older adults aged 55+ years. Studies targeting specific disease populations or promoting weight loss were excluded. RESULTS Thirty-one experimental and quasi-experimental studies with generally unclear to high risk of bias were included. Interventions included nutrition education with behaviour change techniques (BCT) (e.g. goal setting, interactive cooking demonstrations) (n 21), didactic nutrition education (n 4), interactive nutrition education (n 2), food access (n 2) and nutrition education with BCT and food access (n 2). Group-based nutrition education with BCT demonstrated the most promise in improving food and fluid intake, nutritional status and healthy eating knowledge compared with baseline or control. The impact on mobility outcomes was unclear. CONCLUSIONS Group-based nutrition education with BCT demonstrated the most promise for improving healthy eating among community-dwelling older adults. Our findings should be interpreted with caution related to generally low certainty, unclear to high risk of bias and high heterogeneity across interventions and outcomes. Higher quality research in group-based nutrition education for older adults is needed.
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Affiliation(s)
- Kylie Teggart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Rebecca Ganann
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Davneet Sihota
- Global Health Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Caroline Moore
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Heather Keller
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Christine Senson
- Healthy and Safe Communities Department, City of Hamilton Public Health Services, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ONL8S 4L8, Canada
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32
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Hadfield-Spoor M, Avendano M, Loopstra R. Food insecurity among disabled adults. Eur J Public Health 2022; 32:593-599. [PMID: 35560213 PMCID: PMC9341842 DOI: 10.1093/eurpub/ckac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The relationship between disability and food insecurity is under-researched. Risk of food insecurity may vary by type and number of disabilities. We examine the hypotheses that (i) a higher number of disabilities increases risk of food insecurity and (ii) associations of physical disabilities, mental/cognitive disabilities or a combination of both types with food insecurity may differ in strength. Methods Data came from the fifth wave of the UK’s Food Standards Agency’s Food and You survey (2018), which contains detailed information on disability and household food insecurity. We used logistic and multinomial logistic regression to model the number and type of disabilities as predictors for food insecurity outcomes, controlling for socio-demographic factors. Results Both type and number of disabilities predicted food insecurity. Every additional disability was associated with higher odds of food insecurity [odds ratio (OR): 1.60, 95% confidence interval (CI): 1.40–1.83]. Among people with a disability, every additional disability was associated with 19% higher odds of food insecurity (OR: 1.19, 95% CI: 1.05–1.34). People with both physical and mental/cognitive disabilities had increased odds of severe food insecurity (OR: 8.97, 95% CI: 3.54–22.7). Conclusion Number and type of disabilities are associated with higher risk of food insecurity. A combination of physical and mental/cognitive disabilities, as well as having multiple disabilities are each independently associated with higher risk of food insecurity. Policy-makers may thus consider using targeted and tailored policies to reduce barriers to social and financial inclusion of disabled people to reduce food insecurity.
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Affiliation(s)
| | - Mauricio Avendano
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Rachel Loopstra
- Department of Nutritional Sciences, King's College London, London, UK
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33
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Brucker DL, Stott G, Phillips KG. Food sufficiency and the utilization of free food resources for working-age Americans with disabilities during the COVID-19 pandemic. Disabil Health J 2022; 15:101297. [PMID: 35339409 DOI: 10.1016/j.dhjo.2022.101297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Working-age people with disabilities are an economically disadvantaged population more likely than those without disabilities to live in food insecure households. OBJECTIVE/HYPOTHESIS Compare rates of food sufficiency and utilization of free food sources between working-age persons with and without disabilities in the US during the COVID-19 pandemic. METHODS In September 2020, an online survey was conducted with n = 13,270 working-age individuals with and without disabilities to gather information about food sufficiency prior to COVID-19 (i.e., in March 2020) and within the last seven days as well as receipt of free groceries or meals, use of food programs or pantries, and concerns with using free food sources over the past week. Descriptive and multivariate statistics were used to compare these measures for persons with and without disabilities. RESULTS Controlling for sociodemographic characteristics, the proportion of working-age persons who were food sufficient decreased from March 2020 to September 2020 for persons with disabilities (59%-53%, a six-percentage point decrease) and for persons without disabilities (77%-73%, a four-percentage point decrease). The rates of change were not significantly different between groups. In September 2020, higher proportions of persons with disabilities (57%) used free food resources in the past week than persons without disabilities (41%). CONCLUSIONS The low rate of food sufficiency, the high rate of free food resource utilization, and the concerns noted by working-age persons with disabilities in using these sources suggest a need for continuing nutrition assistance policy and program development targeted towards the needs of persons with disabilities.
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Affiliation(s)
- Debra L Brucker
- University of New Hampshire, Institute on Disability, 10 West Edge Drive, Suite 101, Durham, NH, 03824, USA.
| | - Grace Stott
- University of New Hampshire, Institute on Disability, 10 West Edge Drive, Suite 101, Durham, NH, 03824, USA
| | - Kimberly G Phillips
- University of New Hampshire, Institute on Disability, 10 West Edge Drive, Suite 101, Durham, NH, 03824, USA
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34
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Diet Quality and Health in Older Americans. Nutrients 2022; 14:nu14061198. [PMID: 35334855 PMCID: PMC8955752 DOI: 10.3390/nu14061198] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 01/04/2023] Open
Abstract
Adequate nutrition is an essential component of healthy ageing. This study documents the quality of diets among older Americans and implications of healthy eating for their physical and mental health. Using a nationally representative longitudinal sample of adults aged ≥50 years, from the Health and Retirement Study (HRS) 2010−2016 and food intake data from the 2013 Health Care and Nutrition Study (HCNS), the study evaluates the onset of health problems along the spectrum of diet quality measured by the Healthy Eating Index (HEI)-2015. Older adults adhering to healthier diets, in the high HEI group, have a significantly lower risk of developing limitations in activities of daily living (15.2% vs. 19.6%, p < 0.01) and depression (11.8% vs. 14.9%, p < 0.01), as compared to participants with low HEI scores. Consuming healthier diets also predicts more favorable health outcomes, as measured by blood-based biomarkers, including C-reactive protein (3.3 vs. 3.8, p < 0.05), cystatin C (1.1 vs. 1.2, p < 0.1), total cholesterol (192.1 vs. 196.4, p < 0.1), and high-density lipoprotein (57.2 vs. 53.8, p < 0.01). Most older Americans can benefit from improving diet to reduce their risk of disability, chronic disease, and depression.
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Song YLA, Park JH. Differences in Body Mass Index Trajectories and Their Classification, Sociodemographic Characteristics, and Health Behaviors between People with and without Disabilities Using Korea Health Panel Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052827. [PMID: 35270519 PMCID: PMC8910118 DOI: 10.3390/ijerph19052827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022]
Abstract
A high body mass index (BMI) is an important factor that negatively affects the health of people with disabilities. In particular, since the high BMI has a cumulative effect on the occurrence of complications such as cardiovascular disease, it is required to investigate the data through longitudinal studies rather than cross-sectional studies. Therefore, we conducted a longitudinal follow-up study to examine the differences in the BMI trajectories of people in South Korea with disabilities, as well as the sociodemographic characteristics and health behaviors that classify individual trajectories into clusters. Participants aged 40 to 79 years who responded to the Korea Health Panel Survey (KHPS) from 2009 to 2018, 283 people with physical disabilities or brain lesion disorders, and 849 people without disabilities, were extracted. We found that the differences in the initial BMI between clusters were larger in 60-79-year-old people with disabilities (men 22.5 kg/m2, 26.9 kg/m2; women 23.8 kg/m2, 28.1 kg/m2) than in those without disabilities (men 22.1 kg/m2, 23.3 kg/m2; women 24.8 kg/m2, 25.6 kg/m2). Also, logistic regression analysis showed that, among the people with disabilities, women (OR = 1.94), those who lived alone (OR = 2.36), and those who were economically inactive (OR = 1.78) were more likely to be classified into the higher BMI category than those who were not. To effectively manage the BMI, it would be better to focus on women with disabilities, people with disabilities living alone, and people who are economically inactive.
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Affiliation(s)
- Yea-Li-A Song
- Medical Research Institute, Sungkyunkwan University School of Medicine, Suwon 16419, Korea;
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
- Correspondence: ; Tel.: +82-031-299-6301
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Charnes SE. Household disability status, food store choice, and food insecurity in the United States. Physiol Behav 2022; 244:113663. [PMID: 34843797 DOI: 10.1016/j.physbeh.2021.113663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/31/2021] [Accepted: 11/25/2021] [Indexed: 11/26/2022]
Abstract
Disability is a known risk factor for food insecurity, even when accounting for household income. However, the mechanisms driving the relationship between disability and food insecurity remain underexplored. Using the National Household Food Acquisition and Purchase Survey, I test the extent to which food store choice (representing food access) mediates the association between disability and food insecurity in the United States. The analysis is complicated by the notion that food insecurity also influences food store choice. Nevertheless, multivariate regression findings suggest that food access is not a significant driver of high rates of food insecurity among households where disabilities are present.
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Affiliation(s)
- Sarah E Charnes
- Daniel J. Evans School of Public Policy and Governance, University of Washington, Box 353055, Seattle, WA 98195-3055 United States.
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Amin N, Akbari H, Jafarnejad S. Food security, mental health, and socioeconomic status: A cross-sectional study among medical college students in central part of Iran, Kashan. Health Sci Rep 2022; 5:e476. [PMID: 35036577 PMCID: PMC8753500 DOI: 10.1002/hsr2.476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Aims Food security is a complex and multidimensional issue that has been recognized as a serious public health problem all over the world for the past two decades. The present study was designed and conducted to determine the prevalence of food insecurity among college students at the Kashan University of Medical Sciences and some related factors including socioeconomic and mental health determinants. Methods The present study is a cross‐sectional study conducted on 358 students who were currently studying at the Kashan University of Medical Sciences. The students who were pregnant or had a special diet to follow were excluded. Samples were selected by the systematic method. Food security was measured using United States Department of Agriculture. Food Frequency Questionnaire, 21‐items Depression Anxiety Stress Scales, and Socioeconomic Questionnaire were used to investigate the nutrients intake, depression/anxiety status, and socioeconomic factors, respectively. Chi‐square, independent t‐test, and logistic regression were used to analyze the data. Results Based on the findings of the present study, 16.8% of students experienced different levels of food insecurity, and 83.2% of participants were categorized as food secure. Gender, financial assistance, health insurance, depression, and students' occupation are associated with food insecurity (P < .05). Additionally, the results of the logistic regression analysis showed that depression (OR 1.04; 95% CI 1.01‐1.07), and students' jobs (OR 0.43; 95% CI 0.23‐0.80) have the greatest impact on students' food insecurity. Conclusion The findings of the present study show that economic factors and gender have a significant impact on students' food security. Moreover, the association of food insecurity with mental disorders such as depression was demonstrated in the current study. However, we could not detect any significant association between daily energy intake and macronutrients which indicates the requirement for more detailed studies.
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Affiliation(s)
- Negin Amin
- Research Center for Biochemistry and Nutrition in Metabolic Diseases Kashan University of Medical Sciences Kashan Iran
| | - Hossein Akbari
- Social Determinants of Health (SDH) Research Center, Department of Biostatistics and Epidemiology School of Public Health, Kashan University of Medical Sciences Kashan Iran
| | - Sadegh Jafarnejad
- Research Center for Biochemistry and Nutrition in Metabolic Diseases Kashan University of Medical Sciences Kashan Iran
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Rajasooriar D, Soma T. Food access, mobility, and transportation: a survey and key informant interviews of users of non-profit food hubs in the City of Vancouver before and during the COVID-19 crisis. BMC Public Health 2022; 22:6. [PMID: 34983466 PMCID: PMC8726519 DOI: 10.1186/s12889-021-12434-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 12/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the City of Vancouver, Canada, non-profit food hubs such as food banks, neighbourhood houses, community centres, and soup kitchens serve communities that face food insecurity. Food that is available yet inaccessible cannot ensure urban food security. This study seeks to highlight food access challenges, especially in terms of mobility and transportation, faced by users of non-profit food hubs in the City of Vancouver before and during the COVID-19 crisis. METHODS This study involved an online survey (n = 84) and semi-structured follow-up key informant interviews (n = 10) with individuals at least 19 years old who accessed food at a non-profit food hub located in the City of Vancouver more than once before and during the COVID-19 crisis. RESULTS 88.5% of survey respondents found food obtained from non-profit food hubs to be either very or somewhat important to their household's overall diet. In their journey to access food at non-profit food hubs in the City of Vancouver, many survey respondents face barriers such as transportation distance/time, transportation inconveniences/reliability/accessibility, transportation costs, line-ups at non-profit food hubs, and schedules of non-profit food hubs. Comments from interview participants corroborate these barriers. CONCLUSIONS Drawing from the findings, this study recommends that non-profit food hubs maintain a food delivery option and that the local transportation authority provides convenient and reliable paratransit service. Furthermore, this study recommends that the provincial government considers subsidizing transit passes for low-income households, that the provincial and/or federal governments consider bolstering existing government assistance programs, and that the federal government considers implementing a universal basic income. This study emphasizes how the current two-tier food system perpetuates stigma and harms the well-being of marginalized populations in the City of Vancouver in their journey to obtain food.
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Affiliation(s)
- Daniel Rajasooriar
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, Canada
| | - Tammara Soma
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, Canada.
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Food insecurity and geriatric functional limitations: Observational analysis from the AgeHeaPsyWel–HeaSeeB Survey. Exp Gerontol 2022; 160:111707. [DOI: 10.1016/j.exger.2022.111707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/13/2022] [Indexed: 11/18/2022]
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Hearst MO, Hughey L, Magoon J, Mubukwanu E, Ndonji M, Ngulube E, Makhoul Z. Rapid health impact assessment of COVID-19 on families with children with disabilities living in low-income communities in Lusaka, Zambia. PLoS One 2021; 16:e0260486. [PMID: 34910762 PMCID: PMC8673599 DOI: 10.1371/journal.pone.0260486] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 11/10/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Worldwide, children with disabilities are a vulnerable population and at high risk for COVID-19 morbidity and mortality. There is little information on the impact that COVID-19 had on children with disabilities and their families, particularly in low-income settings. This assessment describes the extent to which the pandemic impacted seven indicators of well-being in three low-income communities in Lusaka, Zambia. METHODS Interviews were conducted with a random selection of families participating in an existing program (n = 39), community health workers (n = 6), healthcare workers (n = 7) and government officials (n = 2). Descriptive data was summarized and qualitative responses reviewed for themes. RESULTS Most families reported a major loss of income resulting in food insecurity (79%), housing instability (67%), stress (36%), and increased risk of child separation and neglect (18%). Most families did not report receiving governmental financial assistance and reported loss of access to health services for their child such as physiotherapy (33%). Stakeholders interviewed reported that COVID-19 information was widely available although few specific interventions for children. Families were seen to have greater food insecurity, more poverty, more crowding, less healthcare services and children left alone or on the streets to beg. DISCUSSION COVID-19 and related containment measures have impacted the lives of children with disabilities and their families to a great extent. There is an urgent need for disability-inclusive responses that deliberately address the needs of children with disabilities and their families, notably uninterrupted access to adequate food, inclusive education, rehabilitation therapy, and income-generating activities.
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Affiliation(s)
- Mary O. Hearst
- Public Health Department, Henrietta Schmoll School of Health, St. Catherine University, St. Paul, Minnesota, United States of America
| | | | - Jamie Magoon
- Public Health Department, Henrietta Schmoll School of Health, St. Catherine University, St. Paul, Minnesota, United States of America
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Wetherill MS, Duncan AR, Bowman H, Collins R, Santa-Pinter N, Jackson M, Lynn CM, Prentice K, Isaacson M. Promoting nutrition equity for individuals with physical challenges: A systematic review of barriers and facilitators to healthy eating. Prev Med 2021; 153:106723. [PMID: 34271075 DOI: 10.1016/j.ypmed.2021.106723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/05/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
Impaired mobility is the most common form of functional disability in the US, affecting one out of every sixteen working-age adults. Little is known about the barriers to and facilitators of healthy eating among people with impaired mobility (PWIM), who are at increased risk for diet-related chronic disease. The pathways by which impaired mobility influence dietary intake are unclear, yet likely involve a complex interplay between structural determinants of health and individual factors. To help advance nutrition equity initiatives for PWIM, this systematic review aimed to qualitatively synthesize factors associated with dietary intake across four levels of ecologic influence. An interprofessional team devised a comprehensive search strategy to identify these factors among working-age (18-64 years) PWIM. We queried Ovid MEDLINE, Web of Science, Scopus, and Embase via Ovid for articles published between January 1, 1990 and April 25, 2021. Twelve studies met our review criteria. We classified factors within one of four ecologic levels of influence: individual, social, environmental, and policy/program. Most studies disproportionately reported on personal level factors of influence, with less information on other levels of influence. This systematic review is an important first step for informing the design of evidence-based strategies to support healthy eating among PWIM. However, it also reveals a wide chasm in the needed information to adequately bridge structural determinants of this nutrition divide. More studies are needed that include rigorous measures of dietary intake and that aim to elicit how social, environmental, and policy-level factors contribute to dietary disparities among PWIM.
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Affiliation(s)
- Marianna S Wetherill
- University of Oklahoma Tulsa Schusterman Center, Hudson College of Public Health, Department of Health Promotion Sciences, 4502 E. 41st St., Tulsa, OK 74135, United States of America; University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America.
| | - Ashten R Duncan
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Hartley Bowman
- University of Oklahoma Tulsa Schusterman Center, College of Allied Health, Department of Rehabilitation Sciences, Physical Therapy Program, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Reagan Collins
- University of Oklahoma Tulsa Schusterman Center, College of Allied Health, Department of Rehabilitation Sciences, Occupational Therapy Program, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Natalie Santa-Pinter
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Morgan Jackson
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Catherine M Lynn
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Katherine Prentice
- University of Oklahoma Tulsa Schusterman Center, Schusterman Library, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Mary Isaacson
- University of Oklahoma Tulsa Schusterman Center, College of Allied Health, Department of Rehabilitation Sciences, Occupational Therapy Program, 4502 E. 41st St., Tulsa, OK 74135, United States of America
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Nicklett EJ, Johnson KE, Troy LM, Vartak M, Reiter A. Food Access, Diet Quality, and Nutritional Status of Older Adults During COVID-19: A Scoping Review. Front Public Health 2021; 9:763994. [PMID: 34917577 PMCID: PMC8669368 DOI: 10.3389/fpubh.2021.763994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/08/2021] [Indexed: 12/11/2022] Open
Abstract
Background: COVID-19 has imposed challenges for older adults to access food, particularly in minority, lower income, and rural communities. However, the impact of COVID-19 on food access, diet quality, and nutrition of diverse older adult populations has not been systematically assessed. Objective: To examine changes in food access, diet quality, and nutritional status among older adults during the COVID-19 pandemic and the potential differential impacts of the COVID-19 pandemic on these nutrition-related outcomes using the framework of the socio-ecological model. Methods: An electronic search was conducted on 3 databases (PubMed, CINAHL, and Web of Science) on March 7, 2021. Original, peer-reviewed English-language studies published 10/1/2019-3/1/2021 were considered for which the mean age of participants was 50 years and older. In order to be considered, studies must have examined food access, food security, or nutrition constructs as an outcome. Results: The initial search yielded 13,628 results, of which 9,145 were duplicates. Of the remaining 4,483 articles, 13 articles were in scope and therefore selected in the final analysis, which can be characterized as descriptive (n = 5), analytical (n = 6), and correlational (n = 2). Studies were conducted among community-dwelling older adult populations (n = 7) as well as those temporarily residing in hospital settings (n = 6) in 10 countries. None of the in-scope studies examined the impact of food programs or specific public policies or disaggregated data by race/ethnicity. Conclusions: More research is needed to examine the impact of COVID-19 on food access/security and the differential barriers experienced by older adult populations.
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Affiliation(s)
- Emily J. Nicklett
- Department of Social Work, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
| | - Kimson E. Johnson
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Sociology, University of Michigan, Ann Arbor, MI, United States
| | - Lisa M. Troy
- School of Public Health & Health Sciences and Commonwealth Honors College, University of Massachusetts Amherst, Amherst, MA, United States
| | - Maitreyi Vartak
- Department of Psychology, College of Liberal and Fine Arts, University of Texas at San Antonio, San Antonio, TX, United States
| | - Ann Reiter
- Department of Social Work, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
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Choi SL, Men F. Food insecurity associated with higher COVID-19 infection in households with older adults. Public Health 2021; 200:7-14. [PMID: 34653739 PMCID: PMC8433037 DOI: 10.1016/j.puhe.2021.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES As a well-documented social determinant of health, food insecurity may be associated with COVID-19 infection in households with older adults. We examined whether older adults were vulnerable to COVID-19 infection during the early pandemic if they were food insecure versus food secure. STUDY DESIGN A cross-sectional study using a nationally representative population-based survey of US older adults. METHODS We used a random subsample of Health and Retirement Study (HRS) drawn in June 2020 (N = 3212). We compared the odds of reporting COVID-19 infection in a household, COVID-19 infection and mortality among acquaintances, and respondent's perceived fair or poor health across household food insecurity status resulted from financial or non-financial barriers. Baseline health and socioeconomic circumstances were adjusted in the models. RESULTS Results showed a higher COVID-19 infection rate among food-insecure households than among their food-secure counterparts during the pandemic. Food insecurity due to non-financial obstacles was associated with greater likelihood of COVID-19 infection both within respondents' households (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.03-2.90) and among their acquaintances (aOR = 1.32, 95% CI: 1.05-1.65). Food insecurity caused by both non-financial and financial constraints was associated with twice the likelihood of knowing someone who died from COVID-19 than their food-secure counterparts (aOR = 2.14, 95% CI: 1.27-3.61). CONCLUSIONS Food insecurity driven by non-financial constraints played an important role in the ongoing pandemic among US older adults. Policies addressing COVID-19 need to recognize the vulnerability of food-insecure older adults beyond lack of monetary resources.
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Affiliation(s)
- S L Choi
- The University of Alabama, 304 Adams Hall, Box 870158, Tuscaloosa, AL 35487, United States.
| | - F Men
- The University of Alabama, 316 Adams Hall, Box 870158, Tuscaloosa, AL 35487, United States
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Friedman C. Food insecurity of people with disabilities who were Medicare beneficiaries during the COVID-19 pandemic. Disabil Health J 2021; 14:101166. [PMID: 34272190 PMCID: PMC8436149 DOI: 10.1016/j.dhjo.2021.101166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, 54 million people in the United States were food insecure (2020). People with disabilities (PWD) who were Medicare beneficiaries were especially vulnerable to food insecurity prior to the pandemic. OBJECTIVE The aim of this study was to explore COVID-19 pandemic food insecurity among PWD who were Medicare beneficiaries. METHODS We conducted a secondary analysis of the United States Census Bureau COVID-19 Household Pulse Survey data about the food security of 70,171 PWD who were Medicare beneficiaries (under 65), and a comparison group of 1.1 million non-Medicare beneficiaries (under 65). Data were weighted using frequency person-weights. RESULTS Only 44.3% of PWD who were Medicare beneficiaries had enough of the foods they wanted to eat during the pandemic. Reasons for food insecurity included: could not afford to purchase more food (56.9%); stores did not have the food they wanted (31.4%); afraid to go out to get more food (30.0%); could not get out to get more food (21.5%); and could not get food delivered (8.5%). PWD who were Medicare beneficiaries were more likely to be food insecure than non-Medicare beneficiaries. There were also disparities in food insecurity among PWD who were Medicare beneficiaries themselves with household size, Medicaid beneficiaries, gender, race, education, martial status, household income, and Supplemental Nutrition Assistance Program (SNAP) all impacting food security. CONCLUSIONS A multipronged approach that addresses not only food-related public health, but also other systems and structures is critical to end food insecurity.
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Affiliation(s)
- Carli Friedman
- CQL | the Council on Quality and Leadership, 100 West Road Suite 300, Towson, MD, 21204, USA.
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Venasse M, Gauthier A, Giroux I, Pilutti LA. Dietary intake and characteristics in persons with multiple sclerosis. Mult Scler Relat Disord 2021; 56:103237. [PMID: 34610566 DOI: 10.1016/j.msard.2021.103237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite growing interest in diet and dietary interventions in persons with multiple sclerosis (PwMS), few studies have examined dietary intake and characteristics within this population. The objectives of this study were to prospectively describe and compare nutrition assessment parameters related to the diet, including daily food intake, nutrient intake, eating behaviours, and other dietary characteristics (i.e., specific diets, food preparation, and food security) between PwMS and controls without multiple sclerosis (MS). METHODS This study used a cross-sectional design in 60 PwMS and 60 matched controls. All participants completed a 3-day food intake record and questionnaires. Dietary intake was analysed with and without supplements using ESHA Food Processor SQL. Differences in dietary intake by group and supplement intake were examined using mixed-model ANOVAs. RESULTS There were differences in average daily micronutrient intake between groups for vitamins D, B12, and C, omega 3 fatty acids, and phosphorous. Through supplement use, PwMS consumed significantly more vitamin D, omega 3 fatty acids, vitamin B12, vitamin C, magnesium, manganese, and zinc than controls. There was no difference in dietary behaviours or other dietary characteristics between groups. CONCLUSIONS Results suggest that dietary intake was similar in persons with and without MS. The few differences in dietary intake between groups were mostly accounted for by supplement intake in PwMS. Further studies are needed to continue exploring dietary intake in PwMS.
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Affiliation(s)
- Myriam Venasse
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Isabelle Giroux
- School of Nutrition Sciences, University of Ottawa, Ottawa, Canada; Institut du Savoir Montfort, Ottawa, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada; Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada.
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Men F, Urquia ML, Tarasuk V. Examining the relationship between food insecurity and causes of injury in Canadian adults and adolescents. BMC Public Health 2021; 21:1557. [PMID: 34399730 PMCID: PMC8367649 DOI: 10.1186/s12889-021-11610-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 08/08/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Food insecurity, as an indicator of socioeconomic disadvantages and a determinant of health, may be associated with injury by increasing risk exposure and hampering risk mitigation. We examined the association between food insecurity and common causes of injury in the general population. METHODS Linking the Canadian Community Health Survey 2005-2017 to National Ambulatory Care Reporting System 2003-2017, this retrospective cohort study estimated incidence of injury-related emergency department (ED) visits by food insecurity status among 212,300 individuals 12 years and above in the Canadian provinces of Ontario and Alberta, adjusting for prior ED visits, lifestyle, and sociodemographic characteristics including income. RESULTS Compared to those in food-secure households, individuals from moderately and severely food-insecure households had 1.16 (95% confidence interval [CI] 1.07-1.25) and 1.35 (95% CI 1.24-1.48) times higher incidence rate of ED visits due to injury, respectively, after confounders adjustment. The association was observed across sex and age groups. Severe food insecurity was associated with intentional injuries (adjusted rate ratio [aRR] 1.81; 95% CI 1.29-2.53) including self-harm (aRR 1.87; 95% CI 1.03-3.40) and violence (aRR 1.79; 95% CI 1.19-2.67) as well as non-intentional injuries (aRR 1.34; 95% CI 1.22-1.46) including fall (aRR 1.43; 95% CI 1.24-1.65), medical complication (aRR 1.39; 95% CI 1.06-1.82), being struck by objects (aRR 1.43; 95% CI 1.07-1.91), overexertion (aRR 1.31; 95% CI 1.04-1.66), animal bite or sting (aRR 1.60; 95% CI 1.08-2.36), skin piercing (aRR 1.80; 95% CI 1.21-2.66), and poisoning (aRR 1.65; 95% CI 1.05-2.59). Moderate food insecurity was associated with more injuries from violence (aRR 1.56; 95% CI 1.09-2.21), falls (aRR 1.22; 95% CI 1.08-1.37), being struck (aRR 1.20; 95% CI 1.01-1.43), and overexertion (aRR 1.25; 95% CI 1.04-1.50). Moderate and severe food insecurity were associated with falls on stairs and being struck in non-sports settings but not with falls on same level or being struck during sports. Food insecurity was not related to transport injuries. CONCLUSIONS Health inequity by food insecurity status extends beyond diseases into differential risk of injury, warranting policy intervention. Researchers and policymakers need to address food insecurity as a social determinant of injury to improve health equity.
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Affiliation(s)
- Fei Men
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
- Department of Consumer Sciences, The University of Alabama, Tuscaloosa, Alabama, USA.
| | - Marcelo L Urquia
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Valerie Tarasuk
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Namin S, Zhou Y, Neuner J, Beyer K. Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7192. [PMID: 34281129 PMCID: PMC8297243 DOI: 10.3390/ijerph18137192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 12/18/2022]
Abstract
There is a growing literature on the association between neighborhood contexts and cancer survivorship. To understand the current trends and the gaps in the literature, we aimed to answer the following questions: To what degree, and how, has cancer survivorship research accounted for neighborhood-level effects? What neighborhood metrics have been used to operationalize neighborhood factors? To what degree do the neighborhood level metrics considered in cancer research reflect neighborhood development as identified in the Leadership for Energy and Environmental Design for Neighborhood Development (LEED-ND) guidelines? We first conducted a review guided by PRISMA extension for scoping review of the extant literature on neighborhood effects and cancer survivorship outcomes from January 2000 to January 2021. Second, we categorized the studied neighborhood metrics under six main themes. Third, we assessed the findings based on the LEED-ND guidelines to identify the most relevant neighborhood metrics in association with areas of focus in cancer survivorship care and research. The search results were scoped to 291 relevant peer-reviewed journal articles. Results show that survivorship disparities, primary care, and weight management are the main themes in the literature. Additionally, most articles rely on neighborhood SES as the primary (or only) examined neighborhood level metric. We argue that the expansion of interdisciplinary research to include neighborhood metrics endorsed by current paradigms in salutogenic urban design can enhance the understanding of the role of socioecological context in survivorship care and outcomes.
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Affiliation(s)
- Sima Namin
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
| | - Yuhong Zhou
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
| | - Joan Neuner
- General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Kirsten Beyer
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
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Cordero ML, Cesani MF. Magnitude and spatial distribution of food and nutrition security during the COVID-19 pandemic in Tucumán (Argentina). Am J Hum Biol 2021; 34:e23632. [PMID: 34174008 PMCID: PMC8420521 DOI: 10.1002/ajhb.23632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/26/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022] Open
Abstract
Objective To describe the magnitude and spatial distribution of household food and nutrition security (FNS) during the COVID‐19 pandemic in Tucumán (Argentina) and identify factors associated with food insecurity. Methods During April and May 2020 a cross‐sectional quantitative study was performed. Data from 3915 households were analyzed. The study of FNS was performed with the Latin American and Caribbean Scale for Food Security. To identify associated factors, bivariate and multivariate logistic regression models were applied. Results Household food insecurity affected 55.9% of the sample (mild: 39.3%, moderate: 10.8%, severe: 5.8%). Analyzing the spatial distribution, the eastern area showed the highest food insecurity prevalence, followed by the south and west areas. Logistic regression analysis showed that household food insecurity varied according to household size, presence of children, socioeconomic status, and health area of residence. Conclusions Household size, presence of children, socioeconomic status and public health area of residence were associated to household food insecurity. The perception of hunger was higher in larger households, in those with low and medium socioeconomic status and in households located in the southern area of the province.
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Affiliation(s)
- María Laura Cordero
- Instituto Superior de Estudios Sociales (ISES), Centro Científico Tecnológico CONICET NOA Sur, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - María Florencia Cesani
- Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina
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Brucker DL, Stott G, Phillips KG. Food sufficiency and the utilization of free food resources for working-age Americans with disabilities during the COVID-19 pandemic. Disabil Health J 2021; 14:101153. [PMID: 34183289 DOI: 10.1016/j.dhjo.2021.101153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/27/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Working-age people with disabilities are an economically disadvantaged population more likely than those without disabilities to live in food insecure households. OBJECTIVE/HYPOTHESIS Compare rates of food sufficiency and utilization of free food sources between working-age persons with and without disabilities in the US during the COVID-19 pandemic. METHODS In September 2020, an online survey was conducted with n = 13,277 working-age individuals with and without disabilities to gather information about food sufficiency prior to COVID-19 (i.e., in March 2020) and within the last seven days as well as receipt of free groceries or meals, use of food programs or pantries, and concerns with using free food sources over the past week. Descriptive and multivariate statistics were used to compare these measures for persons with and without disabilities. RESULTS Controlling for sociodemographic characteristics, the proportion of working-age persons who were food sufficient decreased from March 2020 to September 2020 for persons with disabilities (65%-57%, an eight-percentage point decrease) and for persons without disabilities (78%-73%, a five-percentage point decrease). The rates of change were not significantly different between groups. In September 2020, higher proportions of persons with disabilities (58%) used free food resources in the past week than persons without disabilities (41%). CONCLUSIONS The low rate of food sufficiency, the high rate of free food resource utilization, and the concerns noted by working-age persons with disabilities in using these sources suggest a need for continuing nutrition assistance policy and program development targeted towards the needs of persons with disabilities.
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Affiliation(s)
- Debra L Brucker
- University of New Hampshire, Institute on Disability, 10 West Edge Drive, Suite 101, Durham, NH 03824, USA.
| | - Grace Stott
- University of New Hampshire, Institute on Disability, 10 West Edge Drive, Suite 101, Durham, NH 03824, USA
| | - Kimberly G Phillips
- University of New Hampshire, Institute on Disability, 10 West Edge Drive, Suite 101, Durham, NH 03824, USA
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Karpur A, Vasudevan V, Lello A, Frazier TW, Shih A. Food insecurity in the households of children with autism spectrum disorders and intellectual disabilities in the United States: Analysis of the National Survey of Children's Health Data 2016-2018. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2400-2411. [PMID: 34075809 DOI: 10.1177/13623613211019159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Families of children with autism spectrum disorder are more likely to experience financial strain and resulting food insecurity due to additional cost of care, disparate access to needed services, and loss of income resulting from parental job loss. Utilizing nationally representative data, this analysis indicates that the families of children with autism spectrum disorder and co-occurring intellectual disabilities are twice as likely to experience food insecurity than families of children without disabilities after adjusting for various factors. Several factors, ranging from state-level policies such as Medicaid expansion to individual-level factors such as higher utilization of emergency room services, were associated with the higher prevalence of food insecurity in families of children with autism spectrum disorder and co-occurring intellectual disabilities. Implications of these findings on programs and policies supporting families in the COVID-19 pandemic are discussed.
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