Format

Send to

Choose Destination
J Adolesc Health. 2015 Dec;57(6):601-7. doi: 10.1016/j.jadohealth.2015.08.013.

Food Insecurity and the Burden of Health-Related Social Problems in an Urban Youth Population.

Author information

1
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: tamara.baer@childrens.harvard.edu.
2
Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
3
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.
4
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.

Abstract

PURPOSE:

Our study objectives were to (1) determine the prevalence of food insecurity; (2) examine the association between presence and level of food insecurity with other health-related social problems; and (3) assess the predictive values of a two-item food insecurity screen in an urban youth population.

METHODS:

Patients aged 15-25 years completed a Web-based screening tool. Validated questions were used to identify problems in seven health-related social domains (food insecurity, health care access, education, housing, income insecurity, substance use, and intimate partner violence). Chi-square and Kruskal-Wallis tests and logistic regression models controlled for age, sex, and race/ethnicity, assessed the association between food insecurity and health-related social problems. Predictive values of a two-item food insecurity screen compared with the United States Department of Agriculture Food Security Survey were calculated.

RESULTS:

Among 400 patients (mean age 18 years; 69.2% female; 54.6% black; 58.9% public insurance), 32.5% screened positive for food insecurity. Increasing food insecurity level was significantly associated with cumulative burden of social problems (p < .001). In adjusted analyses, food insecurity was associated with problems with health care access (aOR = 2.6, 95% confidence interval [CI] 1.7-4.1), education (aOR = 2.8, 95% CI 1.6-5.1), housing (aOR = 2.8, 95% CI 1.8-4.4), income insecurity (aOR = 2.3, 95% CI 1.2-4.5), and substance use (aOR = 2.5, 95% CI 1.5-4.3). The two-item screen demonstrated sensitivity of 88.5% and specificity of 84.1%.

CONCLUSIONS:

One-third of youth in sample experienced food insecurity, which was strongly associated with presence of other health-related social problems. The two-item screen effectively detected food insecurity. Food insecurity screening may lead to identification of other health-related social problems that when addressed early may improve adolescent health.

KEYWORDS:

Adolescents; Food insecurity; Health-related social problems; Screening; Social determinants of health; Young adults

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center