Food Security and Diet Among American Indians in the Midwest

Abstract

The purpose of this study was to determine levels of food security among American Indians (AI) living in the Midwest and possible correlations between food security levels and various health outcomes, diet, and demographic variables. This study used a cross-sectional design to determine health behaviors among AI. Participants (n = 362) were recruited by AI staff through various cultural community events in the Midwest, such as powwows and health fairs. Inclusion criteria included the following: age 18 years or older, self-identify as an AI, and willing to participate in the survey. Of all participants, 210 (58%) had either low or very low food security, with 96 in the very low category (26.5%). Participants with very low food security tended to have significantly more chronic conditions. Additional significant differences for very low food security existed by demographic variables, including having no insurance (p < 0.0001) or having a regular primary care provider (p = 0.0354). There was also a significant difference between food security levels and the consumption of fast food within the past week (p value = 0.0420), though no differences were found in fruit and vegetable consumption. AI in our sample had higher levels of food insecurity than those reported in the literature for other racial/ethnic groups. AI and non-Native health professionals should be aware of the gravity of food insecurity and the impact it has on overall health. Additional research is needed to determine specific aspects of food insecurity affecting different Native communities to develop appropriate interventions.

Food Insecurity among American Indian and Alaska Native People: A Scoping Review to Inform Future Research and Policy Needs

“…One article was not accessible for full-text examination ( 21 ). A total of 34 articles reporting on 30 unique studies met the inclusion criteria ( Figure 1 ) ( 15–18 , 22–51 ). When separate articles reported on the same study, the article published later was included in the final synthesis.…”

“…Empirical evidence suggests that AI/AN-led households and individuals are at elevated risk of food insecurity. However, most existing research relies on small or regional samples ( 15 , 16 ). Only 2 studies have independently analyzed the Current Population Survey data, a publicly available, nationally representative quantitative survey that serves as the basis for the annual US report on household food security; the prevalence of food insecurity varied across these studies from 16% to 26% of households surveyed ( 17 , 18 ).…”

Association of food security with cardiometabolic health during young adulthood: cross-sectional comparison of American Indian adults with other racial/ethnic groups

“…In a sample of American Indian adults in rural Oklahoma, adults reporting experiences of food insecurity were more likely to report height and weight values considered obese as well as that they had been told by a doctor, nurse or other health professional that they had diabetes or high blood pressure 31. However, food insecurity was not related to obesity when assessed among American Indian or Alaska Native adults in the California Health Interview Survey30 or related to being told by a healthcare provider that they had high blood pressure or diabetes in a sample of American Indian adults recruited in the Midwest 32. However, these studies often rely on small regional samples and self-report among respondents that they were provided diagnoses by healthcare providers, which can introduce biases related to healthcare access and healthcare utilisation as well as recall.…”

“… 31 However, food insecurity was not related to obesity when assessed among American Indian or Alaska Native adults in the California Health Interview Survey 30 or related to being told by a healthcare provider that they had high blood pressure or diabetes in a sample of American Indian adults recruited in the Midwest. 32 However, these studies often rely on small regional samples and self-report among respondents that they were provided diagnoses by healthcare providers, which can introduce biases related to healthcare access and healthcare utilisation as well as recall. To date, no study has characterised food insecurity in American Indian young adults or examined the associations between food insecurity and cardiometabolic health outcomes in this age group by racial and ethnic classification.…”

“…A handful of independent researchers have characterised food insecurity prevalence among American Indian or Alaska Native-led households 26–29. An even smaller subset of studies have assessed the relationship of food insecurity to chronic diseases in samples of American Indian respondents 30–32. In a sample of American Indian adults in rural Oklahoma, adults reporting experiences of food insecurity were more likely to report height and weight values considered obese as well as that they had been told by a doctor, nurse or other health professional that they had diabetes or high blood pressure 31.…”