Background: Significant evidence supports a relationship between food insecurity and health, but little work has investigated its relationship on all-cause mortality within a high resource country, such as the United States. Objective: The aim of this study was to investigate the relationship between food insecurity and mortality in the US. Methods: Data from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) was matched to National Death Index information for all adults (20 years and older) included in the NHANES database. Cox models were used to study the relationship between mortality and food insecurity, adjusting for relevant covariates in a sequential manner (demographics, comorbidities, lifestyle variables, body mass index (BMI)). Hazard ratios (HR) and 95% confidence interval (CI) were reported for analyses categorizing food insecurity as dichotomous and as four categories. Results: 11.6% of the 20,918 participants (representing 208,789,244 US residents) were food insecure. When food insecurity was dichotomized, there was a 49% higher odds of mortality after adjusting for demographics (HR=1.49, 95%CI 1.19−1.87
We showed that CKD is a significant contributor to the financial burden among individuals with diabetes, and that minorities and the uninsured with CKD may experience barriers in access to care. Our study also provides a baseline national estimate of CKD cost in Diabetes by which future studies can be used for comparison.
BackgroundEmerging health technologies are increasingly being used in health care for communication, data collection, patient monitoring, education, and facilitating adherence to chronic disease management. However, there is a lack of studies on differences in the preference for using information exchange technologies between patients with chronic and nonchronic diseases and factors affecting these differences.ObjectiveThe purpose of this paper is to understand the preferences and use of information technology for information exchange among a nationally representative sample of adults with and without 3 chronic disease conditions (ie, cardiovascular disease [CVD], diabetes, and hypertension) and to assess whether these preferences differ according to varying demographic variables.MethodsWe utilized data from the 2012 and 2014 iteration of the Health Information National Trends Survey (N=7307). We used multiple logistic regressions, adjusting for relevant demographic covariates, to identify the independent factors associated with lower odds of using health information technology (HIT), thus, identifying targets for awareness. Analyses were weighted for the US population and adjusted for the sociodemographic variables of age, gender, race, and US census region.ResultsOf 7307 participants, 3529 reported CVD, diabetes, or hypertension. In the unadjusted models, individuals with diabetes, CVD, or hypertension were more likely to report using email to exchange medical information with their provider and less likely to not use any of the technology in health information exchange, as well as more likely to say it was not important for them to access personal medical information electronically. In the unadjusted model, additional significant odds ratio (OR) values were observed. However, after adjustment, most relationships regarding the use and interest in exchanging information with the provider were no longer significant. In the adjusted model, individuals with CVD, diabetes, or hypertension were more likely to access Web-based personal health information through a website or app. Furthermore, we assessed adjusted ORs for demographic variables. Those aged >65 years and Hispanic people were more likely to report no use of email to exchange medical information with their provider. Minorities (Hispanic, non-Hispanic black, and Asian people) were less likely to indicate they had no interest in exchanging general health tips with a provider electronically.ConclusionsThe analysis did not show any significant association among those with comorbidities and their proclivity toward health information, possibly implying that HIT-related interventions, particularly design of information technologies, should focus more on demographic factors, including race, age, and region, than on comorbidities or chronic disease status to increase the likelihood of use. Future research is needed to understand and explore more patient-friendly use and design of information technologies, which can be utilized by diverse age, race, and education or...
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