Dataset Information

Food Insecurity Is Associated with Depression among a Vulnerable Workforce: Early Care and Education Workers.

ABSTRACT: Objective: We aimed to explore the association between food insecurity and depression among early care and education (ECE) workers, a vulnerable population often working in precarious conditions. Design: We utilized cross-sectional data from a study exploring the effects of wage on ECE centers. Participants were enrolled between August 2017 and December 2018. Food insecurity was measured using the validated six-item U.S. Household Food Security Survey Module and participants were categorized as food secure (score = 0-1), low food security (score = 2-4), and very low food security (score = 5-6). Depression (defined as a score ? 16) was measured using the 20-item Center for Epidemiologic Studies Depression Scale-Revised. We employed a logistic regression model to examine the relationship between food insecurity and depression. All models controlled for marital status, nativity, race/ethnicity, number of children in the household, job title, weekly hours of work, education, income, and study site. Setting: Participants were from Seattle (40%) and South King County (26%), Washington, and Austin, Texas (34%). Participants: Participants included 313 ECE workers from 49 ECE centers. Results: A majority of participants were female, non-Hispanic White, born in the U.S., and did not have children. Compared to being food secure, very low and low food insecurities were associated with a 4.95 (95% confidence interval (CI): 2.29, 10.67) and 2.69 (95% CI: 1.29, 5.63) higher odds of depression, respectively. Conclusions: Policies and center-level interventions that address both food insecurity and depression may be warranted, in order to protect and improve the health of this valuable, yet vulnerable, segment of the U.S. workforce.

SUBMITTER: Loh IH

PROVIDER: S-EPMC7795637 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Food Insecurity Is Associated with Depression among a Vulnerable Workforce: Early Care and Education Workers.

Loh Ivory H IH Oddo Vanessa M VM Otten Jennifer J

International journal of environmental research and public health 20201229 1

<i>Objective:</i> We aimed to explore the association between food insecurity and depression among early care and education (ECE) workers, a vulnerable population often working in precarious conditions. <i>Design:</i> We utilized cross-sectional data from a study exploring the effects of wage on ECE centers. Participants were enrolled between August 2017 and December 2018. Food insecurity was measured using the validated six-item U.S. Household Food Security Survey Module and participants were c ...[more]

PMID: 33383668

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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:BackgroundHousehold food insecurity, a measure of income-related problems of food access, is growing in Canada and is tightly linked to poorer health status. We examined the association between household food insecurity status and annual health care costs.MethodsWe obtained data for 67 033 people aged 18-64 years in Ontario who participated in the Canadian Community Health Survey in 2005, 2007/08 or 2009/10 to assess their household food insecurity status in the 12 months before the survey interview. We linked these data with administrative health care data to determine individuals' direct health care costs during the same 12-month period.ResultsTotal health care costs and mean costs for inpatient hospital care, emergency department visits, physician services, same-day surgeries, home care services and prescription drugs covered by the Ontario Drug Benefit Program rose systematically with increasing severity of household food insecurity. Compared with total annual health care costs in food-secure households, adjusted annual costs were 16% ($235) higher in households with marginal food insecurity (95% confidence interval [CI] 10%-23% [$141-$334]), 32% ($455) higher in households with moderate food insecurity (95% CI 25%-39% [$361-$553]) and 76% ($1092) higher in households with severe food insecurity (95% CI 65%-88% [$934-$1260]). When costs of prescription drugs covered by the Ontario Drug Benefit Program were included, the adjusted annual costs were 23% higher in households with marginal food insecurity (95% CI 16%-31%), 49% higher in those with moderate food insecurity (95% CI 41%-57%) and 121% higher in those with severe food insecurity (95% CI 107%-136%).InterpretationHousehold food insecurity was a robust predictor of health care utilization and costs incurred by working-age adults, independent of other social determinants of health. Policy interventions at the provincial or federal level designed to reduce household food insecurity could offset considerable public expenditures in health care.

Dataset Information

Food Insecurity Is Associated with Depression among a Vulnerable Workforce: Early Care and Education Workers.

Publications

Food Insecurity Is Associated with Depression among a Vulnerable Workforce: Early Care and Education Workers.

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