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慢性疾病负担可预测老年人的粮食不安全状况。

Chronic disease burden predicts food insecurity among older adults.

机构信息

1Division of General Internal Medicine and Center for Aging in Diverse Communities,University of California at San Francisco,1545 Divisadero Street,Box 0320,San Francisco,CA 94115,USA.

2Division of Geriatrics,University of California at San Francisco and San Francisco Veterans Affairs Medical Center,San Francisco,CA,USA.

出版信息

Public Health Nutr. 2018 Jun;21(9):1737-1742. doi: 10.1017/S1368980017004062. Epub 2018 Feb 1.

Abstract

OBJECTIVE

Increased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity.

DESIGN

Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS.

SETTING

USA.

SUBJECTS

Respondents of the 2013 HRS HCNS with household incomes <300 % of the federal poverty line (n 3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0-1, 2-4, ≥5 conditions), with multiple chronic conditions (MCC) defined as ≥2 conditions.

RESULTS

The prevalence of food insecurity was 27·8 %. Compared with those having 0-1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2-4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37).

CONCLUSIONS

A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

摘要

目的

医疗支出的增加可能会给低收入家庭带来预算压力,从而导致粮食不安全。本研究的目的是检验患有更多慢性疾病的老年人是否面临更高的粮食不安全风险。

设计

对 2013 年健康与退休研究(HRS)医疗保健和营养研究(HCNS)的二次分析,该研究与 2012 年全国代表性 HRS 相关联。

地点

美国。

受试者

家庭收入低于联邦贫困线的 2013 年 HRS HCNS 受访者的 3552 人。慢性疾病负担通过同时患有慢性疾病的数量进行分类(0-1、2-4、≥5 种疾病),患有多种慢性疾病(MCC)定义为≥2 种疾病。

结果

粮食不安全的发生率为 27.8%。与患有 0-1 种疾病的人相比,患有 MCC 的人更有可能报告粮食不安全,患有 2-4 种疾病的人的调整后比值比为 2.12(95%CI 1.45,3.09),患有≥5 种疾病的人的调整后比值比为 3.64(95%CI 2.47,5.37)。

结论

大量的慢性疾病负担可能会对老年人的家庭预算造成巨大压力,从而增加他们面临粮食不安全的风险。鉴于老年人粮食不安全的高发生率,在临床环境中对患有 MCC 的人进行粮食不安全筛查可能是必要的,以便向社区粮食资源提供转介。

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