Chronic disease burden predicts food insecurity among older adults

Abstract

Objective Increased out-of-pocket health care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of this study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity. Design Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Survey (HCNS) linked to the 2012 nationally representative HRS. Setting United States. Subjects Respondents of the 2013 HRS HCNS with household incomes <300% of the federal poverty line (n=3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0–1; 2–4; 5+ conditions), with multiple chronic conditions (MCC) defined as ≥ 2 conditions. Results The prevalence of food insecurity was 27.8%. Compared to those with 0–1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2 to 4 conditions being 2.12 (95%CI 1.45, 3.09) and for those with 5 or more conditions being 3.64 (95%CI 2.47, 5.37). Conclusions A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

Midlife vulnerability and food insecurity: Findings from low-income adults in the US National Health Interview Survey

“…In addition, relative to younger adults, middle-aged adults had an increased risk of low and very low food security when health challenges were greatest and older adults had a decreased risk of marginal, low, and very low food security, across all three levels of health challenge. These findings are consistent with research showing that food insecurity is associated with functional limitations and poor health [6,7,21,35,53,54] as well as with research showing that the impact of disability on food insecurity is stronger for working-age adults (ages 25-61) than it is for younger and older adults [16]. The findings add to past work by specifying that period in which disability and health challenges may pose the greatest vulnerable; specifically later, rather than earlier, within the working-age range.…”

A Multicenter Study of Multimorbidity in Older Adult Inpatients in China

“…Multimorbidity increases in parallel with both social deprivation and age, with almost a quarter of the United Kingdom population as a whole and two-thirds of people aged 65 years or over affected (6). In the United States, almost 3 out of 4 older adults reportedly have multiple chronic conditions (7): in 2000, 57 million Americans had multiple chronic conditions and by 2020 this number is expected to grow to 81 million (8). Approximately 65% of patients aged 75 or older living in Tokyo who used medical care had 3 or more co-occurring diseases (9), while in Canada, of the 18% of the total population considered multimorbid, 57% were older than investigations, and substantial treatment burden (16,17).…”

Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

“…Food-insecure individuals tend to make frequent use of the healthcare system [8][9][10][11][12], with a collateral increase in national healthcare expenditures [13]. In parallel, multimorbidity, a common problem during older age, has been shown to have a reciprocal association with food insecurity in the US, with either situation inflating the other [14][15][16][17].…”