Analyses of cross-sectional population survey data in Canada and the United States have indicated that household food insecurity is associated with poorer self-rated health and multiple chronic conditions. The causal inference has been that household food insecurity contributes to poorer health, but there has been little consideration of how adults' health status may relate to households' vulnerability to food insecurity. Our objectives were to examine how the presence of an adult with one or more chronic physical or mental health conditions affects the odds of a household being food insecure and how the chronic ill-health of an adult within a food-insecure household affects the severity of that household's food insecurity. Using household- and respondent-level data available for 77,053 adults aged 18-64 y from the 2007-2008 Canadian Community Health Survey, we applied logistic regression analyses, controlling for household sociodemographic characteristics, to examine the association between health and household food insecurity. Most chronic conditions increased the odds of household food insecurity independent of household sociodemographic characteristics. Compared with adults with no chronic condition, the odds of household food insecurity were 1.43 (95% CI: 1.28, 1.59), 1.86 (95% CI: 1.62, 2.14), and 3.44 (95% CI: 3.02, 3.93) for adults with 1, 2, and 3 or more chronic conditions, respectively. Among food-insecure households, adults with multiple chronic conditions had higher odds of severe household food insecurity than adults with no chronic condition. The chronic ill-health of adults may render their households more vulnerable to food insecurity. This has important practice implications for health professionals who can identify and assist those at risk, but it also suggests that appropriate chronic disease management may reduce the prevalence and severity of food insecurity.

BackgroundHousehold food insecurity is a potent social determinant of health and health care costs in Canada, but understanding of the social and economic conditions that underlie households’ vulnerability to food insecurity is limited.MethodsData from the 2011–12 Canadian Community Health Survey were used to determine predictors of household food insecurity among a nationally-representative sample of 120,909 households. Household food insecurity over the past 12 months was assessed using the 18-item Household Food Security Survey Module. Households were classified as food secure or marginally, moderately, or severely food insecure based on the number of affirmative responses. Multivariable binary and multinomial logistic regression analyses were used to determine geographic and socio-demographic predictors of presence and severity of household food insecurity.ResultsThe prevalence of household food insecurity ranged from 11.8% in Ontario to 41.0% in Nunavut. After adjusting for socio-demographic factors, households’ odds of food insecurity were lower in Quebec and higher in the Maritimes, territories, and Alberta, compared to Ontario. The adjusted odds of food insecurity were also higher among households reliant on social assistance, Employment Insurance or workers’ compensation, those without a university degree, those with children under 18, unattached individuals, renters, and those with an Aboriginal respondent. Higher income, immigration, and reliance on seniors’ income sources were protective against food insecurity. Living in Nunavut and relying on social assistance were the strongest predictors of severe food insecurity, but severity was also associated with income, education, household composition, Aboriginal status, immigration status, and place of residence. The relation between income and food insecurity status was graded, with every $1000 increase in income associated with 2% lower odds of marginal food insecurity, 4% lower odds of moderate food insecurity, and 5% lower odds of severe food insecurity.ConclusionsThe probability of household food insecurity in Canada and the severity of the experience depends on a household’s province or territory of residence, income, main source of income, housing tenure, education, Aboriginal status, and household structure. Our findings highlight the intersection of household food insecurity with public policy decisions in Canada and the disproportionate burden of food insecurity among Indigenous peoples.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6344-2) contains supplementary material, which is available to authorized users.

Background and Purpose Body mass index (BMI) has been associated with ischemic stroke in older populations, but its association with stroke in younger populations is not known. In light of the current obesity epidemic in the United States, the potential impact of obesity on stroke risk in young adults deserves attention. Methods A population-based case-control study design with 1201 cases and 1154 controls was used to investigate the relationship of obesity and young-onset ischemic stroke. Stroke cases were between the ages of 15 and 49. Logistic regression analysis was used to evaluate the association between BMI and ischemic stroke with and without adjustment for co-morbid conditions associated with stroke. Results In analyses adjusted for age, sex, and ethnicity, obesity (BMI > 30 kg/m2) was associated with an increased stroke risk (odds ratio, 1.57, 95% C.I. = 1.28–1.94), although this increased risk was highly attenuated and not statistically significant after adjustment for smoking, hypertension, and diabetes mellitus. Conclusion These results indicate that obesity is a risk factor for young onset ischemic stroke, and suggest that this association may be partially mediated through hypertension, diabetes mellitus, and/or other variables associated with these conditions.

Research in intertemporal choice has been done in a variety of contexts, yet there is a remarkable consensus that future outcomes are discounted (or undervalued) relative to immediate outcomes. In this paper, we (a) review some of the key findings in the literature, (b) critically examine and articulate implicit assumptions, (c) distinguish between intertemporal effects arising due to time preference versus those due to changes in utility as a function of time, and (d) identify issues and questions that we believe serve as avenues for future research. Copyright Springer Science + Business Media, Inc. 2005

The narrow disease focus and lack of co-ordination with national governments call into question the efficiency of funding and sustainability of Global Fund investments in HRH and their effectiveness in strengthening recipient countries' health systems. The lessons that emerge from this analysis can be used by both the Global Fund and other donors to improve co-ordination of investments and the effectiveness of programmes in recipient countries.