Health-Related Quality of Life of Food-Insecure Ethnic Minority Patients With Cancer

Abstract

Purpose: The association between food insecurity and healthrelated quality of life (QOL) of racial/ethnic minority patients with cancer has not been examined. The purpose of this study is to determine the relationship between food insecurity and health-related QOL reported by racial/ethnic minority patients with cancer.Methods: A consecutive sample of 1,390 underserved ethnic minority patients receiving cancer care in 10 cancer clinics and hospitals in New York City participated in this study. Healthrelated QOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G) and food security was assessed by the US Department of Agriculture Core Food Security Module.Results: Of the 1,390 patients, 581 (41.8%) were classified as food secure, 571 (41.1%) with low food security, and 238 (17.1%) with very low food security. Health-related QOL decreased with each lower food security level. Patient self-reported physical, functional, social, and emotional well-being subscale scores decrease significantly with increasing food insecurity. After controlling for demographic and medical-related factors, the decreases in QOL, physical, functional, social and emotional well-being scores with increasing food insecurity remained significant. Conclusion:Food insecurity was associated with lower QOL in this sample of underserved racial/ethnic minority patients with cancer. Underserved ethnic minority patients diagnosed with cancer are a vulnerable patient population, at significant risk for inadequate food access and the related lower QOL.

Household Food Insecurity Is Associated with Adverse Mental Health Indicators and Lower Quality of Life among Koreans: Results from the Korea National Health and Nutrition Examination Survey 2012–2013

“…In line with this, previous studies have documented the relationship between food intake and functional disability such as dressing, bathing, eating, and other activities [44,45,46,47]. Studies on elderly Koreans proposed that frequent consumption of dairy products, legumes, or soy products were inversely related with functional disability [45,47].…”

“…There were relatively limited data on the relationships between food insecurity and QOL; however, an inverse association between food insecurity and QOL has been observed in women [19]. Recent studies on cancer patients also revealed that self-reported physical, functional, social, emotional well-being scores, and QOL decreased with increased levels of food insecurity [44]. The relationship between food insecurity and QOL is complicated, because QOL is composed of multilateral factors such as exercise ability, self-management, daily activities, pain/discomfort, and anxiety/depression.…”

Food insecurity screening: A missing piece in cancer management

“…These studies, which investigated the relationship between food insecurity and cancer incidence, prevalence, outcomes, and distress using cross-sectional samples, are described in Table 1. [22][23][24][25][26][27][28] Population-based studies have suggested that cancer risk is higher among individuals living in food-insecure households (compared with food-secure households). Using data from the National Health Interview Survey, the USDA has generated population-based estimates of the prevalence of many chronic illnesses, including cancer, at increasing levels of food insecurity.…”

“…However, several cross-sectional studies have noted the ways in which food insecurity is experienced by patients with cancer, highlighting the distress it causes and its implications for outcomes in both the intermediate and long term ( Table 1). [22][23][24][25][26][27][28] Simmons et al found that food-insecure patients with cancer had higher financial strain compared with their food-secure counterparts; greater than one-half of food-insecure patients (55%) reported not taking a prescribed medication because they could not afford it, compared with 13% of food-secure patients (P = .002). 22 Similarly, food-insecure patients were more likely to report borrowing money or paying bills late to pay for cancer treatment.…”

“…24,66 This financial burden may be exacerbated by the more expensive dietary requirements that frequently accompany cancer treatment. 24 This financial distress may partially drive the reduced quality of life 22,26 and greater depressive symptoms 22 observed among food-insecure patients with cancer. The results of these studies suggest that food insecurity can be a significant driver of cancer distress, which can lead to treatment nonadherence, increased use of outpatient and emergency department care, greater difficulty in decision making, and poorer quality of life.…”