Associations of food insecurity, socioeconomic status, and type 2 diabetes among Hispanic and non‐Hispanic adults in the NHANES 1999‐2004

Abstract

Hispanics and people with low socioeconomic status (SES) have higher rates of type 2 diabetes (T2D). We examined whether food insecurity and low SES are independently related to T2D among Mexican Americans and non‐Hispanic whites (NHW). About 2955 Mexican Americans and 6363 NHWs, 20‐84yr, from the nationally representative NHANES 1999‐2004 were included in the analyses. Compared to highly food secure people, those with marginal or very low food security were more likely to have T2D after adjusting for education, employment, poverty, gender, age, acculturation, and ethnicity (p<0.05). Following further adjustment for other risk factors (obesity, physical activity, dietary and alcohol intakes, smoking, family history diabetes, and co‐morbidities), only those with very low food security remained to be more likely to have T2D (OR 1.84, CI 1.02‐3.31). When the two ethnic groups examined separately, very low food security became a stronger correlate of T2D among NHWs (OR 3.53, CI 1.58‐7.87); this association was attenuated among Mexican Americans. Low education and unemployment were related to higher likelihood of having T2D among Mexican Americans (p=0.050) but not among NHWs. These results suggest that associations of food insecurity and SES with T2D vary between Mexican Americans and NHWs, and this may require different prevention efforts tailored to the needs of each racial/ethnic group.