Food Insecurity and Mortality in American Adults: Results From the NHANES-Linked Mortality Study
Food Insecurity and Mortality in American Adults: Results From the NHANES-Linked Mortality Study
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DOI：
10.1177/1524839920945927
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发表时间：
2020-08-04
影响因子：
1.9
通讯作者：
Dunn, Patrick
中科院分区：
文献类型：
--
作者：
Banerjee, Srikanta;Radak, Tim;Dunn, Patrick
粮食不安全是美国的一个重大公共卫生问题，导致大量的社会，经济和医疗保健相关的负担。虽然研究继续估计粮食不安全的普遍程度，但长期结果没有得到广泛探讨。这项研究的目的是评估粮食不安全对死亡率的影响。我们分析了1999-2010年国家健康和营养检查调查中的成年人（≥ 20岁）数据，以及截至2015年的死亡率数据。在所有研究参与者（n = 25，247）中，17.6%报告粮食不安全。与食物安全的人相比，食物不安全的人更有可能年龄更小，少数民族，更穷，教育程度更低，肥胖，吸烟者和糖尿病患者。在10.2年的随访中，在粮食不安全的人群中，有821人死亡（11%）。仅调整年龄和性别后，粮食不安全者与粮食安全者的死亡率风险比（HR）为1.58; 95%置信区间[CI：1.25，2.01]。在调整多个人口统计学和健康风险因素后，食物不安全个体的全因死亡率（HR = 1.46，CI [1.23，1.72]，p <0.001）和心血管死亡率（HR = 1.75，CI [1.19，2.57]，p <0.01）的调整HR在统计学上显著较高。在长期随访中，粮食不安全的人死于任何原因或心血管疾病的概率明显更高。应采取全面和跨学科的办法，减少与粮食不安全有关的差距和健康风险。将粮食不安全纳入健康风险评估，并将粮食不安全作为长期结果的一个决定因素加以处理，可能有助于降低过早死亡率。
Food insecurity is a significant public health problem in the United States leading to substantial social, economic, and health care-related burdens. While studies continue to estimate the prevalence of food insecurity, the long-term outcomes are not extensively explored. The purpose of this study was to assess the impact of food insecurity on mortality. We analyzed data on adults (>= 20 years) from the 1999-2010 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. Among the total study participants (n = 25,247), 17.6% reported food insecurity. Food-insecure individuals were more likely to be younger in age, minorities, poorer, with lesser education, obese, smokers, and with diabetes compared to food-secure counterparts. During a 10.2-year follow-up, among the food insecure, 821 individuals died (11%). The hazard ratio (HR) for mortality among the food insecure compared with the food secure, with adjustment for age and gender only, was 1.58; 95% confidence interval [CI: 1.25, 2.01]. The adjusted HRs for all-cause mortality, HR = 1.46, CI [1.23, 1.72], p < .001, and cardiovascular mortality, HR = 1.75, CI [1.19, 2.57], p < .01, were statistically significantly higher among food-insecure individuals, after adjustment for multiple demographic and health risk factors. Individuals who are food-insecure have a significantly higher probability of death from any cause or cardiovascular disease in long-term follow-up. Comprehensive and interdisciplinary approaches to reducing food insecurity-related disparities and health risks should be implemented. Including food insecurity in health risk assessments and addressing food insecurity as a determinant of long-term outcomes may contribute to lower premature death rates.