Very Low Food Security in US Households Is Predicted by Complex Patterns of Health, Economics, and Service Participation
Very Low Food Security in US Households Is Predicted by Complex Patterns of Health, Economics, and Service Participation
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DOI：
10.3945/jn.117.253179
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发表时间：
2017-10-01
影响因子：
4.2
通讯作者：
Frongillo, Edward A.
中科院分区：
文献类型：
--
作者：
Choi, Seul Ki;Fram, Maryah S.;Frongillo, Edward A.
背景：极低粮食安全（VLFS）发生在多个领域微妙而复杂的风险特征模式的交叉点。人们对导致家庭经历VLFS的特殊情况知之甚少。目的：我们使用分类和回归树（CART）分析，该分析可以处理复杂的预测因子组合，以识别区分美国VLFS家庭与其他家庭的特征模式。方法：数据来源于2011-2014年全国健康访谈调查（NHIS）、2005-2012年NHANES和2002-2012年流动人口调查（CPS） 3项调查，样本参与者年龄为18岁，家庭收入为65岁（NHANES）。家庭食品安全使用10项美国成人食品安全量表进行测量。来自多个领域的变量，包括社会人口特征、健康、医疗保健、社会福利和食品援助计划的参与，被认为是预测因素。采用CART分析法对3个数据源分别进行分析。结果：对不同类型的家庭而言，家庭经历与不同的预测因子相关，并且经常发生在多种特征的交叉点，包括未满足的医疗需求、健康状况不佳、残疾、限制、抑郁症状、低收入和食品援助计划的参与。这些预测器在不同类型的家庭中建立了不同组合的复杂树。结论：本研究表明，跨多个领域的多个特征区分了VLFS家庭。应采用侧重于广泛风险特征的灵活和非线性方法来识别VLFS家庭，并为能够满足VLFS家庭各种需求的政策和计划提供信息。
Background: Very low food security (VLFS) happens at the intersection of nuanced and complex patterns of risk characteristics across multiple domains. Little is known about the idiosyncratic situations that lead households to experience VLFS.Objective: We used classification and regression tree (CART) analysis, which can handle complex combinations of predictors, to identify patterns of characteristics that distinguish VLFS households in the United States from other households.Methods: Data came from 3 surveys, the 2011-2014 National Health Interview Survey (NHIS), the 2005-2012 NHANES, and the 2002-2012 Current Population Survey (CPS), with sample participants aged >= 18 y and households with income = 65 y (NHANES). Household food security was measured with the use of the 10-item US Adult Food Security Scale. Variables from multiple domains, including sociodemographic characteristics, health, health care, and participation in social welfare and food assistance programs, were considered as predictors. The 3 data sources were analyzed separately with the use of CART analysis.Results: Household experiences of VLFS were associated with different predictors for different types of households and often occurred at the intersection of multiple characteristics spanning unmet medical needs, poor health, disability, limitation, depressive symptoms, low income, and food assistance program participation. These predictors built complex trees with various combinations in different types of households.Conclusions: This study showed that multiple characteristics across multiple domains distinguished VLFS households. Flexible and nonlinear methods focusing on a wide range of risk characteristics should be used to identify VLFS households and to inform policies and programs that can address VLFS households' various needs.