Abstract 14135: Food Insecurity and Inadequate Health Insurance Coverage are Barriers to Ideal Cardiovascular Health for U.S. Adults: Data From the National Health and Nutrition Examination Survey (NHANES)
Introduction: Little is known about the association between cardiovascular (CV) health and social determinants including food security and health insurance coverage. We hypothesized that U.S. adults with food insecurity, or difficulty affording enough food at the household or individual level, and inadequate health insurance coverage would have a lower likelihood of ideal CV health.
Methods and Results: Using 2009-2010 NHANES data, we examined the relationship between social determinants of health and ideal CV health in adults aged ≥19 years (N=1124). Ideal CV health was defined as meeting 6-7 health metrics set forth by the American Heart Association (AHA) 2020 Impact Goals. Household- and individual-level food insecurity (none, marginal, or high) was measured using the validated Food Security Survey Module and health insurance coverage (yes/no) were determined by survey. Logistic regression modeling was used to determine the relationship between each social determinant of health and the odds of ideal CV health. Less than 10% of U.S. adults had ideal CV health. Those with ideal CV health were more likely to be female (70±3% vs. 34±3%) and college-educated (58±5% vs. 18±3%) compared to those with poor CV health (p <0.001). After adjustment for age, sex, race, education, and income, adults with high household-level food insecurity had a 58% decreased odds of ideal CV health versus those with no food insecurity (Table). High individual-level food insecurity and lack of health insurance coverage were also associated with a lower likelihood of ideal CV health when adjusting for age, sex, and race; however, these relationships were attenuated by education and income.
Conclusions: U.S. adults with food insecurity and inadequate health insurance coverage are significantly less likely to have ideal CV health. Efforts targeting these social determinants of health may improve CV health and the ability to achieve the AHA 2020 Impact Goals.
- © 2013 by American Heart Association, Inc.