The association between housing and food insecurity among medically underserved cancer patients

Abstract

Purpose To assess the prevalence of socioeconomic needs and associations between housing characteristics and food insecurity among low-income cancer patients, among whom housing and food insecurity are particularly prevalent. Methods Low-income cancer patients in active treatment (N = 1618) were enrolled in a comprehensive patient navigation program. Food insecurity was assessed using the 18-item US Department of Agriculture US Household Food Security Survey Module. Participants self-reported their need for assistance with housing issues/type of assistance needed, perception of overcrowding, satisfaction with living situation, and household density via a cross-sectional survey. Descriptive analyses, cross-tabulations and tests of proportions, and binary logistic regression were used in data analyses. Results Seventy percent of patients were food insecure. Housing characteristics associated with food insecurity were homelessness or living in sheltered/supportive housing (83.3% food insecure), renting (71.9%), and homeownership (58.1%; p < .001); living situation satisfaction (not satisfied, 79.4%; somewhat satisfied, 25.6%; very satisfied, 66%; p < .001); need of housing assistance (79.2%; p < .001), and feeling crowded in their living unit (77.6%; p < .05). Associations of living unit type with food insecurity were significant in the binary logistic regression model (renters 1.68 OR, homeless/sheltered housing 2.80 OR vs homeowners). ConclusionThe vulnerability to food insecurity of patients in this low-income sample was underlined by the high rates found, and clear associations with housing characteristics of homelessness, housing assistance needs, and feeling overcrowded were identified. These results could help shape priorities around screening patients for nutrition and housing needs and developing interventions to address them.

Navigating financial toxicity in patients with cancer: A multidisciplinary management approach

“…For this patient, indicators are whether he has the resources to meet his basic needs and pay for medical expenses. Food insecurity is one of his most acute, severe reported needs 83 . The case is an example of the prevalence and severity of basic needs privations in patients with FT.…”

“…Food insecurity is one of his most acute, severe reported needs. 83 The case is an example of the prevalence and severity of basic needs privations in patients with FT. In one large study of low-income, primarily publicly insured patients with cancer who were receiving treatment, nearly 70% had food insecurity, including running out of food before being able to buy more, cutting the size of or skipping meals, being hungry, not eating for a whole day, and/ or losing weight because they did not have enough money for food.…”

Age at diagnosis and social risks among Black cancer survivors: Results from the Detroit Research on Cancer Survivors cohort

“…We 32 and much lower than in some other cancer-related populations, including underserved oncology patients in New York (56%-70%) 9,11,12,33 or in a population-based cohort of survivors in New Mexico (58%). 34 In an analysis of the 2017 Behavioral Risk Factor Surveillance System, Coughlin and Datta estimated that 16.6% of adults with a history of cancer reported housing insecurity, 15 which is somewhat higher than our estimate of 11.3%.…”

“…4,[7][8][9] Social risks are consistently found to be more common among racial and ethnic minorities and low-income populations compared with other groups, and these disparities are also observed among cancer survivors. Food insecurity is more than twice as common in Black cancer survivors compared with White cancer survivors, 10 and the prevalence of food insecurity among low-income and medically underserved patients who have cancer can be as high as 55%-70%, 11,12 compared with approximately 10% in the US population. 13 Among cancer survivors, 3.1% reported delays in care because of lack of transportation; however, the prevalence of transportation insecurity was approximately four times as high among cancer survivors with incomes below the federal poverty level.…”

The Potential of Cancer Care Settings to Address Food Insecurity

“…[8][9][10][11][12] As in the general population, food insecurity is more than twice as common in Black compared with White cancer survivors, 11 and estimates of food insecurity among low-income and medically underserved patients with cancer can be as high as 55%-70%. 13,14 Food insecurity is also more prevalent among young adult cancer survivors, who typically have fewer assets than older adults and are largely dependent on employment for both income and health insurance. 8 There is broad agreement that people with cancer should be screened for social needs, including food insecurity, but there is no clear path to addressing those needs when found.…”