Exploring Sociodemographic and Chronic Disease Factors Associated With Chronic, Seasonal, Intramonthly, and Intermittent Presentations of Food Security Instability

Graham E Bastian

doi:10.1016/j.jand.2023.12.002

Exploring Sociodemographic and Chronic Disease Factors Associated With Chronic, Seasonal, Intramonthly, and Intermittent Presentations of Food Security Instability

J Acad Nutr Diet. 2023 Dec 9:S2212-2672(23)01720-3. doi: 10.1016/j.jand.2023.12.002. Online ahead of print.

Author

Graham E Bastian¹

Affiliation

¹ School of Health and Consumer Sciences, South Dakota State University, Brookings, South Dakota. Electronic address: graham.bastian@sdstate.edu.

PMID: 38081383
DOI: 10.1016/j.jand.2023.12.002

Abstract

Background: Food insecurity impacts 13.5 million US households yearly. Although food security instability (FS-I) can have many temporal presentations, these are not measured in the current US Household Food Security Survey Module.

Objective: Explore sociodemographic and chronic disease correlates of 4 FS-I types (chronic, seasonal, intramonthly, and intermittent) using a 3-item US Household Food Security Survey Module instability supplement.

Design: This study was a secondary analysis of cross-sectional survey pilot data collected to validate the US Household Food Security Survey Module instability supplement.

Participants and setting: Adults at risk for food insecurity (n = 420) were recruited and answered the survey on their households' behalf from April to June 2021. The participants were recruited from 7 community organizations from 5 states (California, Florida, Maryland, North Carolina, and Washington).

Main outcome measures: The main outcomes were the odds of having a chronic, seasonal, intramonthly, or intermittent FS-I score ≥1 based on several sociodemographic factors and having ≥1 chronic disease.

Statistical analyses performed: Differences among the 4 FS-I types were analyzed using contingency tables and χ² tests of independence. Then, mixed-effects logistic binary and conditional regressions were run for each FS-I type using clustering by state and odds ratios and 95% CI to interpret results.

Results: The most common FS-I type experienced by the sample was intramonthly (n = 183 [43%]). Nonchronic food insecurity was most likely to happen during the winter, at the end of the month, or randomly with no certain time frame. FS-I in any form was associated with low income, chronic FS-I was associated with younger age and male sex, seasonal FS-I was associated with having no government-subsidized health insurance and females, intramonthly FS-I was associated with participation in nutrition assistance programs, and intermittent FS-I had lower odds among Hispanic/Latino households.

Conclusions: Further research is needed to explore other FS-I correlates and establish causative relationships; however, these results can be used with clinical judgment for targeted food insecurity screening and treatment.

Keywords: Chronic disease; Cross-sectional studies; Food insecurity; Secondary data analysis; Sociodemographic factors.