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Abstract: PO2023

Trends in the Prevalence of Food Insecurity Across Racial-Ethnic Groups with CKD: An Analysis of NHANES 2003-2016

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Banerjee, Tanushree, University of California San Francisco, San Francisco, California, United States
  • Crews, Deidra C., Johns Hopkins University, Baltimore, Maryland, United States
  • McCulloch, Charles E., University of California San Francisco, San Francisco, California, United States
  • Burrows, Nilka Rios, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Siegel, Karen R., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Han, Yun, University of Michigan, Ann Arbor, Michigan, United States
  • Powe, Neil R., University of California San Francisco, San Francisco, California, United States
Background

Food insecurity has been associated with CKD and its progression. Trends in food insecurity among adults with CKD have not been well characterized in the US population, particularly across racial/ethnic groups.

Methods

Data from NHANES from 2003-2016 were used to estimate the prevalence of food insecurity among individuals with CKD (defined by albuminuria or eGFR 15-59 ml/min/1.73 m2), overall and by racial/ethnic group. We included individuals aged≥20 years and with a household income≤400% of the federal poverty level (n=3180). Food insecurity was defined as ≥3 yes responses on the 18-item questionnaire. Racial/ethnic groups were defined as non-Hispanic white (NHW) and non-NHW. Survey years were collapsed into time periods 2003-2006, 2007-2010, and 2011-2016. Prevalence rates were estimated after standardization to the 2010 age population distribution from the US Census. Log binomial regression model was used to estimate adjusted risk ratios (RR) for the association of food insecurity and racial/ethnic groups.

Results

Overall prevalence of food insecurity in adults with CKD was 19.9%. During the period, the age-standardized prevalence rate of food insecurity increased from 5.7% to 32.8% among NHW and from 23.2% to 35.8% among non-NHW (p-trend=0.001). After adjusting for age, sex, education level, and annual household income, non-NHW had a significantly higher prevalence of food insecurity compared to NHW in 2007-2010 but not in 2003-2006 or 2011-2016 (Figure).

Conclusion

From 2003 to 2016, food insecurity among both NHW and non-NHW increased, with the highest RR among non-NHW compared to NHW during 2007-2010. One potential explanation may be the US economic recession during that period. Targeted interventions such as medically tailored meals for individuals with CKD and poverty may be evaluated for their impact on reducing healthcare utilization and costs and in reversing the increasing trend in food insecurity.

Funding

  • Other U.S. Government Support