Treat or Eat: Food Insecurity, Cost-related Medication Underuse, and Unmet Needs
Treat or Eat: Food Insecurity, Cost-related Medication Underuse, and Unmet Needs
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DOI：
10.1016/j.amjmed.2014.01.002
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发表时间：
2014-04-01
影响因子：
5.9
通讯作者：
Choudhry, Niteesh K.
中科院分区：
文献类型：
--
作者：
Berkowitz, Seth A.;Seligman, Hilary K.;Choudhry, Niteesh K.
背景技术背景：患有慢性病的成年人往往无法满足药物和食物需求，但没有研究在全国代表性样本中审查与成本有关的药物使用不足与粮食不安全之间的关系。方法：对2011年全国健康访谈调查中年龄≥ 20岁的慢性病参与者（自报关节炎、糖尿病、癌症、哮喘、慢性阻塞性肺病、中风、高血压、冠心病或存在“精神问题”）的数据进行横断面分析。我们拟合logistic回归模型，以确定与食品不安全，成本相关的药物使用不足，或both.RESULTS：有9696成人国家健康访谈调查（NHIS）参与者谁报告慢性病; 23.4%的报告成本相关的药物使用不足; 18.8%的报告食品不安全;和11%的报告。报告食物不安全的成年人更有可能报告与成本相关的药物使用不足（调整后的比值比[aOR] 4.03）。与费用相关的药物使用不足和食物不安全的参与者更有可能是西班牙裔（aOR 1.58），非西班牙裔黑人（aOR 1.58），并且有更多的慢性疾病（aOR每额外的慢性疾病1.56）。他们也不太可能有公共的，非医疗保险（aOR 0.70），并报告参与特别补充营养援助计划的妇女，婴儿和儿童（aOR 0.39）。结论：约1/3的慢性病NHIS参与者无法负担食物，药物，或两者兼而有之。WIC和公共健康保险参与与较少的粮食不安全和与成本相关的药物使用不足有关。(C)2014 Elsevier Inc. All rights reserved.
BACKGROUND: Adults with chronic disease are often unable to meet medication and food needs, but no study has examined the relationship between cost-related medication underuse and food insecurity in a nationally representative sample. We examined which groups most commonly face unmet food and medication needs.METHODS: Cross-sectional analysis of data from chronically ill participants (self-report of arthritis, diabetes mellitus, cancer, asthma, chronic obstructive pulmonary disease, stroke, hypertension, coronary heart disease, or presence of a "psychiatric problem") aged >= 20 years, in the 2011 National Health Interview Survey. We fit logistic regression models to identify factors associated with food insecurity, cost-related medication underuse, or both.RESULTS: There were 9696 adult National Health Interview Survey (NHIS) participants who reported chronic illness; 23.4% reported cost-related medication underuse; 18.8% reported food insecurity; and 11% reported both. Adults who reported food insecurity were significantly more likely to report cost-related medication underuse (adjusted odds ratio [aOR] 4.03). Participants with both cost-related medication underuse and food insecurity were more likely to be Hispanic (aOR 1.58), non-Hispanic black (aOR 1.58), and have more chronic conditions (aOR per additional chronic condition 1.56) than patients reporting neither. They also were less likely to have public, non-Medicare insurance (aOR 0.70) and report participation in the Special Supplemental Nutrition Assistance Program for Woman, Infants, and Children (aOR 0.39).CONCLUSIONS: Approximately 1 in 3 chronically ill NHIS participants are unable to afford food, medications, or both. WIC and public health insurance participation are associated with less food insecurity and cost-related medication underuse. (C) 2014 Elsevier Inc. All rights reserved.