Chronic Physical and Mental Health Conditions among Adults May Increase Vulnerability to Household Food Insecurity

Abstract

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.

High vulnerability to household food insecurity in a sample of Canadian renter households in government-subsidized housing

“…The selection of indicators of household material circumstances was informed by previous literature documenting household conditions related to food insecurity [4][5][6][7]14,15,23 and by the necessity to achieve parsimony due to the small sample size. Since food insecurity is measured at the household level, the selected characteristics described the household rather than the individual.…”

“…Presence of senior(s) ≥65 years of age identified households entitled to federally-funded old-age benefit programs; in this sample, more than 90% of households with a senior were reliant primarily on seniors' income, which has been associated with lower risk of food insecurity. 1,6,7 Receipt of social assistance was used as a marker of financial vulnerability distinct from the low income of recipients, given the independent relationship between reliance on social assistance and food insecurity found in population-based studies. [4][5][6][7] This heightened vulnerability may be attributed to the limited ability of social assistance recipients to draw on savings and other assets to weather unexpected financial shock, 24,25 since welfare programs require applicants to expend most of their liquid assets for eligibility.…”

“…1,6,7 Receipt of social assistance was used as a marker of financial vulnerability distinct from the low income of recipients, given the independent relationship between reliance on social assistance and food insecurity found in population-based studies. [4][5][6][7] This heightened vulnerability may be attributed to the limited ability of social assistance recipients to draw on savings and other assets to weather unexpected financial shock, 24,25 since welfare programs require applicants to expend most of their liquid assets for eligibility. 26 A household was considered to have a member with disability if a member's amount or kind of activity at home, at work, at school, or in other activities was often reduced by a physical/mental condition or health problem.…”

“…1 Studies from Canada and the United States have demonstrated that household food insecurity is a major public health problem, associated with elevated health care costs 2 and numerous adverse health outcomes. 3 The social epidemiology of food insecurity is well documented in Canada, with multiple characteristics indicative of financial vulnerability identified as risk factors, including low income [4][5][6][7] and renting versus owning a dwelling. [5][6][7][8] A recent multilevel analysis revealed a positive association between average rental cost in census metropolitan areas and food insecurity, 7 suggesting that the heightened vulnerability of renter households may be influenced by the cost of rents.…”

“…3 The social epidemiology of food insecurity is well documented in Canada, with multiple characteristics indicative of financial vulnerability identified as risk factors, including low income [4][5][6][7] and renting versus owning a dwelling. [5][6][7][8] A recent multilevel analysis revealed a positive association between average rental cost in census metropolitan areas and food insecurity, 7 suggesting that the heightened vulnerability of renter households may be influenced by the cost of rents. Although social housing programs are not designed to address household food insecurity, they may play a role in mitigating the issue, given the emerging evidence that food insecurity is sensitive to interventions that increase households' incomes.…”