Food Insecurity and the Burden of Health-Related Social Problems in an Urban Youth Population

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• 作者：Tamara E. Baer ; M.D. ; M.P.H.^a ; ^b ; ^{tamara.baer@childrens.harvard.edu" class="auth_mail" title="E-mail the corresponding author} ; Emily A. Scherer ; Ph.D.^c ; ^d ; Eric W. Fleegler ; M.D. ; M.P.H.^b ; ^e ; ¹ ; Areej Hassan ; M.D. ; M.P.H.^a ; ^b ; ¹
• 关键词：Adolescents ; Young adults ; Food insecurity ; Social determinants of health ; Health-related social problems ; Screening
• 刊名：Journal of Adolescent Health
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：57
• 期：6
• 页码：601-607
• 全文大小：530 K

文摘

Our study objectives were to (1) determine the prevalence of food insecurity; (2) examine the association between presence and level of food insecurity with other health-related social problems; and (3) assess the predictive values of a two-item food insecurity screen in an urban youth population.

Methods

Patients aged 15–25 years completed a Web-based screening tool. Validated questions were used to identify problems in seven health-related social domains (food insecurity, health care access, education, housing, income insecurity, substance use, and intimate partner violence). Chi-square and Kruskal-Wallis tests and logistic regression models controlled for age, sex, and race/ethnicity, assessed the association between food insecurity and health-related social problems. Predictive values of a two-item food insecurity screen compared with the United States Department of Agriculture Food Security Survey were calculated.

Results

Among 400 patients (mean age 18 years; 69.2% female; 54.6% black; 58.9% public insurance), 32.5% screened positive for food insecurity. Increasing food insecurity level was significantly associated with cumulative burden of social problems (p < .001). In adjusted analyses, food insecurity was associated with problems with health care access (aOR = 2.6, 95% confidence interval [CI] 1.7–4.1), education (aOR = 2.8, 95% CI 1.6–5.1), housing (aOR = 2.8, 95% CI 1.8–4.4), income insecurity (aOR = 2.3, 95% CI 1.2–4.5), and substance use (aOR = 2.5, 95% CI 1.5–4.3). The two-item screen demonstrated sensitivity of 88.5% and specificity of 84.1%.

Conclusions

One-third of youth in sample experienced food insecurity, which was strongly associated with presence of other health-related social problems. The two-item screen effectively detected food insecurity. Food insecurity screening may lead to identification of other health-related social problems that when addressed early may improve adolescent health.