Latinos With Diabetes and Food Insecurity in an Agricultural Community

Abstract

Background Latinos from agricultural communities have a high prevalence of food insecurity and are at increased risk of obesity and diabetes, yet little is known about the associations between food insecurity and diabetes outcomes. Objective To examine the associations between food insecurity and diabetes outcomes among rural Latinos. Methods Cross-sectional survey with medical chart abstraction of 250 Latinos with diabetes. Primary outcomes are the control of three intermediate diabetes outcomes (hemoglobin A1C ≤ 8.0%, LDL-cholesterol ≤ 100 mg/dl, and blood pressure ≤ 140/90 mmHg), a composite of control of the three, and receipt of 6 processes of care. Secondary outcomes are cost-related medication underuse and participation in self-care activities. Results Fifty-two percent of patients reported food insecurity and one-in-four reported cost-related medication underuse. Patients with food insecurity were more likely to report cost-related medication underuse (adjusted odds ratio [AOR] =2.49; 95% confidence intervals [CI] 1.30, 4.98; p = 0.003); less likely to meet the composite measure for control of the 3 intermediate outcomes (AOR 0.24; 95% CI 0.07, 0.84; p < 0.05), and less likely to receive a dilated eye exam (AOR 0.37; 95% CI 0.18, 0.77; p < 0.05) and annual foot exams (AOR 0.42; 95% CI 0.20, 0.84; p < 0.05) compared to those who were food secure. Conclusion Among this rural Latino population, food insecurity was independently associated with not having control of the intermediate diabetes outcomes captured in the composite measure, not receiving dilated eye and foot exams, and with self-reporting cost-related medication underuse.

Negative health outcomes associated with food insecurity status in the United States of America: A systematic review of peer-reviewed studies

“…We identified seventeen peer-reviewed USA articles studying the association between FIS and diabetes (29,55,61,82,107,109,(111)(112)(113)(114)(115)(116)(137)(138)(139)(140). Of those manuscripts, twelve of them show a significant association (Table S2- patterns which may be difficult for FIS individuals (141).…”

“…Although one study did find an association between proxy-reported low birth weight and FIS(51). (64,86,112,116,(148)(149)(150)(151)(152)(153)(154)(155)(156)(157)(158)(159), from which 14 studies found a significant association between the two variables (Table S2-9). These studies included, among others, older adults (64,148,151), caregivers (149), immigrants (152), college students (156), and the general public (116).…”

Implementation of a food insecurity screening and referral program in student-run free clinics in San Diego, California

“…1) (United States Department of Agriculture Economic Research Se, Bickel et al, 2000). This tool is commonly used in research conducted on food insecurity in clinical settings (Seligman et al, 2012, Seligman et al, 2015, Moreno et al, 2015, Burkhardt et al, 2012). The 6-item survey has been found to be an acceptable alternative to the longer surveys as it correctly categorizes 97.7% of households when compared to the longer 10-item and 18-item formats (United States Department of Agriculture Economic Research Se, Bickel et al, 2000, Blumberg et al, 1999).…”

Prácticas de alimentación y salud entre trabajadores agrícolas migrantes en Miguel Alemán, Sonora, México.

“…Las autoras concluyen que la relación entre salud y nutrición es un tema prioritario en la atención las personas trabajadoras agrícolas en Sonora. Pero esto no solo ocurre en México, ya que entre población jornalera agrícola en Estados Unidos también se ha reportado la inseguridad alimentaria (Kiehne y Mendoza, 2015) y su relación con la diabetes (Moreno et al, 2015).…”