Housing and Food Insecurity, Health Literacy, and Maladaptive Coping Behaviors.
Housing and Food Insecurity, Health Literacy, and Maladaptive Coping Behaviors.
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DOI：
10.3928/24748307-20221019-01
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发表时间：
2022-10
影响因子：
--
通讯作者：
Fleary SA
中科院分区：
文献类型：
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作者：
Joseph PL;Applewhite J;Fleary SA
与健康的社会决定因素有关的压力因素，如住房和粮食不安全，与慢性病风险有关。应对这些压力源的适应不良策略可能会加剧风险。鉴于对SDH相关压力源和适应不良应对的研究有限，本研究探讨了两种SDH相关压力源（住房和粮食不安全）与适应不良应对行为（即，情绪化饮食和与压力有关的吸烟和饮酒）。此外，因为健康素养（HL），另一个SDH，可能是一个保护因素，本研究探讨HL是否调节这些关系。数据收集自美国成人（N = 500，平均年龄= 49.01岁，标准差= 16.36; 40%为白色）。一系列分层逻辑回归预测适应不良的应对行为，从人口统计学，SDH相关的压力源（即，住房或粮食不安全）和HL变量进行了估计。住房不安全与情绪化进食（比值比[OR] = 1.48，p < .001），压力相关的吸烟（OR = 1.34，p = .001）和压力相关的饮酒（OR = 1.32，p = .001）的几率增加相关。食物不安全与情绪化饮食（OR = 1.49，p = 0.012）、压力相关吸烟（OR = 1.68，p = 0.002）和压力相关饮酒（OR = 1.49，p = 0.013）的几率增加相关。较高的功能性HL评分与考虑住房（OR = 0.79，p = 0.017）和食物不安全（OR = 0.76，p = 0.004）后情绪性进食的几率降低相关。沟通和批判HL调节食物不安全和情绪化饮食之间的关系。检查HL与SDH相关的压力源和适应不良的应对行为是复杂的。HL可能对可能成瘾的适应不良应对行为的保护性较低。由于HL领域可能需要个人和系统之间的合作，与压力源，多系统的干预是必要的，以减少适应不良的应对行为。[HLRP健康素养研究与实践。2022;6（4）：e280-e289.]与住房和食物资源不足有关的压力可能与成年人的不良应对行为有关（例如，情绪化饮食和与压力有关的吸烟和饮酒）。经历过住房和粮食不安全的成年人更有可能在压力下报告情绪化饮食和使用香烟和酒精。功能性健康素养较高的成年人不太可能报告情绪化饮食。
Stressors related to social determinants of health (SDH), such as housing and food insecurity, are implicated in chronic disease risk. Maladaptive strategies for coping with these stressors may exacerbate risk. Given the limited research on SDH-related stressors and maladaptive coping, this study examined the relationship between two SDH-related stressors (housing and food insecurity) and maladaptive coping behaviors (i.e., emotional eating and stress-related cigarette and alcohol use) in adults. Further, because health literacy (HL), another SDH, may be a protective factor, this study explored whether HL moderated these relationships. Data were collected from adults (N = 500, Mean age = 49.01 years, standard deviation = 16.36; 40% White) in the United States. A series of hierarchical logistic regressions predicting maladaptive coping behaviors from demographics, SDH-related stressors (i.e., housing or food insecurity), and HL variables were estimated. Housing insecurity was associated with increased odds of emotional eating (odds ratio [OR] = 1.48, p < .001), stress-related cigarette use (OR = 1.34, p = .001), and stress-related alcohol use (OR = 1.32, p = .001). Food insecurity was associated with increased odds of emotional eating (OR = 1.49, p = .012), stress-related cigarette (OR = 1.68, p = .002), and stress-related alcohol use (OR = 1.49, p = .013). Higher functional HL scores were associated with decreased odds of emotional eating after accounting for housing (OR = 0.79, p = .017) and food insecurity (OR = 0.76, p = .004). Communicative and critical HL moderated the relationship between food insecurity and emotional eating. Examining HL in relation to SDH-related stressors and maladaptive coping behaviors is complex. HL may be less protective for maladaptive coping behaviors that are likely addictive. Because HL domains may require cooperation between individuals and systems related to stressors, multi-systemic interventions are necessary to reduce maladaptive coping behaviors. [HLRP: Health Literacy Research and Practice. 2022;6(4):e280–e289.] Stress related to inadequate resources for housing and food may be related to adults' poor coping behaviors (e.g., emotional eating and stress-related cigarette and alcohol use). Adults who experienced housing and food insecurity were more likely to report emotional eating and using cigarettes and alcohol when stressed. Adults with higher functional health literacy were less likely to report emotional eating.