Adverse Consequences of Food Insecurity Among US Adults Beyond Health Outcomes

Introduction: Food insecurity is associated with poorer health, but the adverse consequences of food insecurity may extend beyond just health outcomes. Thus, this study examined the association between food insecurity and health insurance coverage, access to care, healthcare utilization, and financial hardships among U.S. adults.Methods: This study employed a retrospective longitudinal cohort study design using panel data from the 2016-2017 Medical Expenditure Panel Survey. Linear probability models were used to examine the association between food insecurity in 1 year and outcomes of interest (health insurance coverage, access to care, healthcare utilization, and financial hardships) in the subsequent year. Analysis was conducted in April 2023.Results: Food insecurity was associated with higher uninsured rates and lower private coverage rates (3.5 [95% CI: 1.6-5.5] and -3.9 [95% CI: -6.2, -1.7] percentage points). Moreover, food insecurity was associated with lower access to care, including delay in receiving necessary medical care and delay in obtaining necessary prescription drugs (2.9 [95% CI: 1.0-4.8] and 4.1 [95% CI: 2.1-6.2]). Furthermore, food insecurity was associated with a higher rate of emergency room visits (2.8 [95% CI: 0.1-5.7]), whereas associations with inpatient, outpatient, and prescription drug use were not significant. Food insecurity was also associated with greater financial hardships, such as experiencing difficulties paying medical bills (9.6 [95% CI:Conclusions: These findings highlight the adverse consequences of food insecurity on access to and affordability of care for U.S. adults and families. Food insecurity can have far-reaching implicaAm J Prev Med 2024;66(1):146-153.(c) 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.