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315264
Racial and gender differences in the association between food insecurity and type 2 diabetes

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 5:15 PM - 5:30 PM

Sabrina Strings, Ph.D. Sociology , School of Public Health/Department of Sociology, University of California, Berkeley, Berkeley, CA
Background:  Food insecurity (FI), or limited financial resources for food, has been associated with an increased risk of type-2 diabetes (T2D). Although African Americans and Latinos have the highest rates of FI, little is known about how the relationship between FI and T2D may vary by gender and race/ethnicity. In this study, we examined whether the relationship between FI and T2D varied by race/ethnicity and gender.

Methods: We analyzed data from low-income (<=200% federal poverty level) adults aged 18 or older participating in the 2009 and 2011 waves of the California Health Interview Survey (CHIS) (N=27,798). Participants responded to a series of questions adapted from the USDA guidelines probing food security and self-reported whether they had been diagnosed with T2D at each exam. We used logistic regression models to estimate the gender and race-specific associations between FI and T2D.

Results: In white women, we observed a positive association between severe FI and T2D (adjusted odds ratio (OR) (95% confidence interval (CI)) = 1.6 (1.1, 2.5)), but no association between mild FI and T2D.  In white men, we observed a positive association between mild FI and T2D (OR (CI) = 1.9 (1.2, 3.2)) but no association with severe FI.  In Latinas, we observed a positive association between both mild FI (OR (CI) = 1.7 (1.3, 2.2)) and severe FI (OR (CI) = 1.8 (1.2, 2.6)) and T2D.  In Latinos, we observed a positive association between severe FI and T2D (OR (CI) = 1.7 (1.1, 2.7)), but no association between mild FI and T2D.  We did not observe any associations between FI and T2D in African-American women and men in this sample.

Conclusion: Our findings suggest that food insecurity is associated with type 2 diabetes among Latinos and Whites, but not among African Americans. For African Americans, limited geographic access to food resulting from residential segregation, rather than food insecurity, may be a more significant driver of increased risk of diabetes.  Future research should examine the extent to which local food availability may modify the effect of food insecurity on T2D across racially diverse populations.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Epidemiology
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Identify the racial/ethnic and gender differences in the association between food insecurity and diabetes.

Keyword(s): Food Security, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for this study. I am also the PI for another study using population-based survey data to examine the role of local access to healthy food in rates of diabetes among low-income people of color. Further, I am a member of the food insecurity research team at UC Berkeley-UCSF and one of our objectives is to produce a white paper on food insecurity in the U.S.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4419.0: Topics in Social and Health Disparities