Food Insecurity and Cost-Related Medication Underuse Among Nonelderly Adults in a Nationally Representative Sample

Abstract

Objectives. We investigated whether nonelderly US adults (aged 18–64 years) in food-insecure households are more likely to report cost-related medication underuse than the food-secure, and whether the relationship between food insecurity and cost-related medication underuse differs by gender, chronic disease, and health insurance status. Methods. We analyzed data from the 2011 and 2012 National Health Interview Survey (n = 67 539). We examined the relationship between food insecurity and cost-related medication underuse with the χ2 test and multivariate logistic regression with interaction terms. Results. Bivariate and multivariate analyses showed a dose–response relationship between food insecurity and cost-related medication underuse, with an increasing likelihood of cost-related medication underuse with increasing severity of food insecurity (P < .001). This association was conditional on health insurance status, but not substantially different by gender or chronic disease status. Being female, low-income, having no or partial health insurance, chronic conditions, functional limitations, or severe mental illness were positively associated with cost-related medication underuse. Conclusions. Using food insecurity as a risk factor to assess cost-related medication underuse could help increase identification of individuals who may need assistance purchasing medications and improve health for those in food-insecure households.

Prescription medication nonadherence associated with food insecurity: a population-based cross-sectional study

“…Despite the removal of adolescents and 2 provinces from our sample, the prevalence of cost-related nonadherence to prescription drugs was virtually the same as that reported by Law and colleagues 5 using the same data. Similar to findings from US-based studies, 16,21,22 after adjustment for confounders, we for respondents with and without prescription drug insurance by household food insecurity status; 332 respondents with missing insurance status were excluded from the analysis. Poisson regression with bootstrapped standard error was used, adjusting for household income, imputed income, income source, sex, age, Aboriginal status, housing tenure, household type, province of residence and number of different drugs prescribed.…”

Who Is Food Insecure? Implications for Targeted Recruitment and Outreach, National Health and Nutrition Examination Survey, 2005–2010

“…This practice also hampers our ability to understand whether recruitment and outreach strategies are equally effective among different subpopulations of people who are food insecure. Secondary analyses of survey data and other population-based studies ( 4 , 13 ) contribute to this knowledge gap by failing to stratify participation in food assistance programs. Therefore, people who are food insecure may be inadvertently characterized as belonging to a monolithic population with homogeneous patterns of health care use, health status, and food assistance.…”

Housing and Food Insecurity, Care Access, and Health Status Among the Chronically Ill: An Analysis of the Behavioral Risk Factor Surveillance System

“…A meta-analysis of 47 studies found that lower level of education, racial discrimination, lack of social support, and poverty were factors in over one third of all deaths in the United States in 2000. 32 Food insecurity increases the likelihood of cost-related medication underuse, 33 which can lead to poorer health status. Poverty can also negatively impact patient health care utilization, as those who struggle financially may prioritize meeting their basic needs over seeking health care.…”