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Depression, food insecurity and diabetic morbidity: Evidence from the Health and Retirement Study.

ABSTRACT: OBJECTIVE:This study examined whether diabetic morbidity mediates the relationship of food insecurity with depression among older adults with diabetes. METHODS:Data came from the 2010-2014 waves of the Health and Retirement Study and analyses were limited to respondents with diabetes (n?=?2951). Depression was indexed by the 8-item Centers for Epidemiologic Studies Depression Scale. Weighted logistic regression was used to examine relationships of food insecurity and diabetic morbidity with depressive symptoms, both cross-sectionally and longitudinally. Path analysis quantified the contribution of diabetic morbidity as a mediation of the relationship of food insecurity with depressive symptoms. RESULTS:Food insecurity was associated with having poor diabetes control (odds ratio (OR)?=?1.7; 95% confidence interval (CI)?=?1.1-2.5) and diabetes-related kidney problems (OR?=?1.6; 95% CI?=?1.1-2.5). Additionally, food insecurity was associated with depression contemporaneously (OR?=?2.0, 95% CI?=?1.7-2.4) and longitudinally (OR?=?1.5, 95% CI?=?1.3-1.8). However, food insecurity was no longer associated with depression when adjusting for diabetic morbidity. In path analyses, diabetic morbidity explained 12.7% (p-value?=?.04) of the association of food insecurity with depressive symptoms in 2012 and 18.5% (p-value?=?.09) of the association with depressive symptoms in 2014. CONCLUSION:The relationship of food insecurity with depression was attributable to worse diabetes morbidity. Interventions that reduce food insecurity among older adults with diabetes may improve disease management and reduce depression severity.

SUBMITTER: Bergmans RS

PROVIDER: S-EPMC6467465 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Depression, food insecurity and diabetic morbidity: Evidence from the Health and Retirement Study.

Bergmans Rachel S RS Zivin Kara K Mezuk Briana B

Journal of psychosomatic research 20181219

<h4>Objective</h4>This study examined whether diabetic morbidity mediates the relationship of food insecurity with depression among older adults with diabetes.<h4>Methods</h4>Data came from the 2010-2014 waves of the Health and Retirement Study and analyses were limited to respondents with diabetes (n = 2951). Depression was indexed by the 8-item Centers for Epidemiologic Studies Depression Scale. Weighted logistic regression was used to examine relationships of food insecurity and diabetic morb ...[more]

PMID: 30665592

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Project description:ImportanceFood insecurity is a leading public health issue in the US. Research on food insecurity and cognitive aging is scarce, and is mostly cross-sectional. Food insecurity status and cognition both can change over the life course, but their longitudinal relationship remains unexplored.ObjectiveTo examine the longitudinal association between food insecurity and changes in memory function during a period of 18 years among middle to older-aged adults in the US.Design, setting, and participantsThe Health and Retirement Study is an ongoing population-based cohort study of individuals aged 50 years or older. Participants with nonmissing information on their food insecurity in 1998 who contributed information on memory function at least once over the study period (1998-2016) were included. To account for time-varying confounding and censoring, marginal structural models were created, using inverse probability weighting. Data analyses were conducted between May 9 and November 30, 2022.Main outcomes and measuresIn each biennial interview, food insecurity status (yes/no) was assessed by asking respondents whether they had enough money to buy food or ate less than they felt they should. Memory function was a composite score based on self-completed immediate and delayed word recall task of a 10-word list and proxy-assessed validated instruments.ResultsThe analytic sample included 12 609 respondents (mean [SD] age, 67.7 [11.0] years, 8146 [64.60%] women, 10 277 [81.51%] non-Hispanic White), including 11 951 food-secure and 658 food-insecure individuals in 1998. Over time, the memory function of the food-secure respondents decreased by 0.045 SD units annually (β for time, -0.045; 95% CI, -0.046 to -0.045 SD units). The memory decline rate was faster among food-insecure respondents than food-secure respondents, although the magnitude of the coefficient was small (β for food insecurity × time, -0.0030; 95% CI, -0.0062 to -0.00018 SD units), which translates to an estimated 0.67 additional (ie, excess) years of memory aging over a 10-year period for food-insecure respondents compared with food-secure respondents.Conclusions and relevanceIn this cohort study of middle to older-aged individuals, food insecurity was associated with slightly faster memory decline, suggesting possible long-term negative cognitive function outcomes associated with exposure to food insecurity in older age.

Project description:BackgroundDespite recent progress in rural economic development and food production, the prevalence of household food insecurity (FI) and use of unimproved toilet facilities are widespread in Bangladesh. Evidence regarding the consequencs of household FI and poor sanitation on child morbidity is scarce. This study aimed to understand the association of FI and unimproved toilet facility with morbidity status of under-5 children in Bangladesh.MethodsWe used data from a cross-sectional survey that was conducted as part of an evaluation of the Maternal, Infant and Young Child Nutrition (MIYCN) Program in 9 districts of Bangladesh. The study population included children aged 6-59 months and their caregivers, identified using a two-stage cluster-sampling procedure. Child morbidity status was the outcome variable, and household FI status and type of toilet used were considered the main exposure variables in this study. We performed logistic regression, calculated adjusted odds ratios (AOR) to assess the association of child morbidity with household FI and unimproved toilet facility after adjusting for potential confounders.ResultsA total of 1,728 households were eligible for this analysis. About 23% of the households were food-insecure, and a large number of households had improved toilet facilities (93.4%). In the multivariable logistic regression model, we found that children in food-insecure households with unimproved toilet facility had 5.88 (AOR: 5.88; 95% CI 2.52, 13.70) times more chance, of being morbid compared to the children of food-secure households with improved toilet facility. A similar association of FI and toilet facilities with each of the morbidity components was observed, including diarrhea (AOR:3.6; 95% CI 1.79, 7.89), fever (AOR:3.47; 95% CI 1.72, 6.99), difficult or fast breathing with cough (AOR:3.88; 95% CI 1.99, 7.59), and difficult or fast breathing with blocked or running nose (AOR:1.29; 95% CI 0.56, 2.95).ConclusionsOur study shows that household FI and unimproved toilet facility jointly have more deteriorative effects on child morbidity than either of these conditions alone. Therefore, it is recommended to consider these two critical factors while designing a public health intervention for reducing morbidity among under-five children.

Project description:ObjectiveTo disentangle the relationships among food insecurity, health care utilization, and health care expenditures.Data sources/study settingWe use national data on 13 465 adults (age ≥ 18) from the 2016 Medical Expenditure Panel Survey (MEPS), the first year of the food insecurity measures.Study designWe employ two-stage empirical models (probit for any health care use/expenditure, ordinary least squares, and generalized linear models for amount of utilization/expenditure), controlling for demographics, health insurance, poverty status, chronic conditions, and other predictors.Principal findingsOur results show that the likelihood of any health care expenditure (total, inpatient, emergency department, outpatient, and pharmaceutical) is higher for marginal, low, and very low food secure individuals. Relative to food secure households, very low food secure households are 5.1 percentage points (P < .001) more likely to have any health care expenditure, and have total health care expenditures that are 24.8 percent higher (P = .011). However, once we include chronic conditions in the models (ie, high blood pressure, heart disease, stroke, emphysema, high cholesterol, cancer, diabetes, arthritis, and asthma), these underlying health conditions mitigate the differences in expenditures by food insecurity status (only the likelihood of any having any health care expenditure for very low food secure households remains statistically significant).ConclusionsPolicy makers and government agencies are focused on addressing deficiencies in social determinants of health and the resulting impacts on health status and health care utilization. Our results indicate that chronic conditions are strongly associated with food insecurity and higher health care spending. Efforts to alleviate food insecurity should consider the dual burden of chronic conditions. Finally, future research can address specific mechanisms underlying the relationships between food security, health, and health care.

Project description:BackgroundFood insecurity adversely affects human health, which means food security and nutrition are crucial to improving people's health outcomes. Both food insecurity and health outcomes are the policy and agenda of the 2030 Sustainable Development Goals (SDGs). However, there is a lack of macro-level empirical studies (Macro-level study means studies at the broadest level using variables that represent a given country or the whole population of a country or economy as a whole. For example, if the urban population (% of the total population) of XYZ country is 30%, it is used as a proxy variable to represent represent country's urbanization level. Empirical study implies studies that employ the econometrics method, which is the application of math and statistics.) concerning the relationship between food insecurity and health outcomes in sub-Saharan African (SSA) countries though the region is highly affected by food insecurity and its related health problems. Therefore, this study aims to examine the impact of food insecurity on life expectancy and infant mortality in SSA countries.MethodsThe study was conducted for the whole population of 31 sampled SSA countries selected based on data availability. The study uses secondary data collected online from the databases of the United Nations Development Programme (UNDP), the Food and Agricultural Organization (FAO), and the World Bank (WB). The study uses yearly balanced data from 2001 to 2018. This study employs a multicountry panel data analysis and several estimation techniques; it employs Driscoll-Kraay standard errors (DKSE), a generalized method of momentum (GMM), fixed effects (FE), and the Granger causality test.ResultsA 1% increment in people's prevalence for undernourishment reduces their life expectancy by 0.00348 percentage points (PPs). However, life expectancy rises by 0.00317 PPs with every 1% increase in average dietary energy supply. A 1% rise in the prevalence of undernourishment increases infant mortality by 0.0119 PPs. However, a 1% increment in average dietary energy supply reduces infant mortality by 0.0139 PPs.ConclusionsFood insecurity harms the health status of SSA countries, but food security impacts in the reverse direction. This implies that to meet SDG 3.2, SSA should ensure food security.

Project description:BackgroundThis study examines the association between food insecurity and mental health of women during the COVID-19 pandemic in a resource poor setting.Materials and methodsData were collected at two time-points (wave 1 and 2) from 2402 women, one per household, participating in a larger study during extended COVID-19 lockdown in the rural areas of the southwest region of Bangladesh. The primary outcome of the analyses is the association between food insecurity, measured using the Food Insecurity Experience Scale (FIES), and stress level, measured using the Perceived Stress Scale (PSS), for women during the lockdown. General awareness about COVID-19 and attitude towards prescribed preventive measures were also measured since COVID-19 health concerns could exacerbate food insecurity.ResultsAn individual-level evaluation of the effect of wave 2 FIES score on PSS score showed that worsening of the food security status increasing the stress level of the participants (95% CI: 1.61; 2.13; p-value: <0.001). Additionally, a significant negative association was observed between the PSS score and change in food security status between the two waves (Coefficient: -1.15, 95% CI: -1.30; -0.99, p-value: <0.001), indicating that deterioration in food security status over the pandemic period increasing the stress level. At the village level, the results showed a similar pattern. General awareness around ways coronavirus spreads was high, yet there were misperceptions at a higher level. Maintaining hand hygiene, wearing face masks outside the home, and going outside only when necessary were widely practised. Fewer respondents could maintain a 1.5-metre distance from others in the outside and maintained cough and sneeze etiquette.ConclusionThe results indicate a higher stress level, a potential contributor to poor mental health, as food insecurity deteriorated. Policy initiatives in ameliorating immediate food insecurity during crises, improving long-term wellbeing, and expanding the reach of mental health support are warranted.

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Depression, food insecurity and diabetic morbidity: Evidence from the Health and Retirement Study.

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Depression, food insecurity and diabetic morbidity: Evidence from the Health and Retirement Study.

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