Functional limitation and chronic diseases are associated with food insecurity among U.S. adults: National Health Interview Survey, 2011

Certain chronic diseases are more prevalent in food insecure populations than food secure populations. Little research has examined the association of functional limitation with food insecurity. We examined associations of functional limitation due to any health problems and six chronic diseases (arthritis, diabetes, coronary heart disease, heart attack, hypertension, and stroke) with food security. We conducted secondary analyses using the 2011 National Health Interview Survey for 30,010 adults (≥18 y). Adults were categorized into food secure, low food secure or very low food secure. We used multivariate logistic regressions to estimate adjusted odds ratio (aOR) and 95% CI for having functional limitation and chronic disease in low food secure or very low food secure compared to food secure group, while adjusting for sociodemographic and lifestyle factors. The prevalence of functional limitation and the chronic diseases were higher in low food secure and very low food secure than food secure adults. The aORs (95% CIs) for functional limitation were 1.87 (1.63, 2.14) in low food secure and 2.19 (1.91, 2.52) in very low food secure. The range of aORs (95% CIs) were from 1.26 (1.06, 1.51) for diabetes to 1.51 (1.12, 2.04) for stroke in low food secure, and from 1.23 (1.02, 1.48) for diabetes to 1.75 (1.37, 2.24) for coronary heart disease in the very low food secure compared to food secure adults. Our findings indicate that food insecurity is associated with functional limitation and chronic diseases, while directionality is unknown. Interventions for the food insecure populations should address not only food accessibility but also a healthy lifestyle to reduce chronic diseases and functional limitation.