Dataset Information

Physical Disability and Older Adults' Perceived Food and Economic Insecurity During the COVID-19 Pandemic.

ABSTRACT:

Objectives

We examined whether older adults with physical disability were vulnerable to three types of perceived economic insecurity (difficulty paying regular bills, difficulty paying medical bills, and income loss) and two types of perceived food insecurity (economic obstacles and logistical obstacles) during the early months of the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the extent to which associations are moderated by three personal characteristics (age, sex, and race/ethnicity) and two pandemic-specific risk factors (job loss and COVID-19 diagnosis).

Method

Data are from a random 25% subsample of Health and Retirement Study participants who completed a COVID-19 module introduced in June 2020. We estimated logistic regression models to predict each of five self-reported hardships during the pandemic.

Results

Bivariate analyses showed that persons with three or more functional limitations were more likely to report both types of food insecurity, and difficulty paying regular and medical bills since the start of the pandemic, relative to those with no limitations. After controlling for health conditions, effects were no longer significant for paying medical bills, and attenuated yet remained statistically significant for other outcomes. Patterns did not differ significantly on the basis of the moderator variables. Job loss substantially increased the risk of economic insecurity but not food insecurity.

Discussion

Older adults with more functional limitations were vulnerable to economic and food insecurity during the pandemic, potentially exacerbating the physical and emotional health threats imposed by COVID-19. Supports for older adults with disability should focus on logistical as well as financial support for ensuring their food security.

SUBMITTER: Choi SL

PROVIDER: S-EPMC8522401 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Physical Disability and Older Adults' Perceived Food and Economic Insecurity During the COVID-19 Pandemic.

Choi Shinae L SL Carr Deborah D Namkung Eun Ha EH

The journals of gerontology. Series B, Psychological sciences and social sciences 20220701 7

<h4>Objectives</h4>We examined whether older adults with physical disability were vulnerable to three types of perceived economic insecurity (difficulty paying regular bills, difficulty paying medical bills, and income loss) and two types of perceived food insecurity (economic obstacles and logistical obstacles) during the early months of the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the extent to which associations are moderated by three personal characteristics (age, sex, and ...[more]

PMID: 34491329

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Project description:ImportanceEvidence from diverse global populations suggests that household food insecurity (HFI) is associated with adult disability, but the association between household water insecurity (HWI) and disability remains understudied. Examinations of the joint association of dual HFI and HWI with disability are lacking.ObjectiveTo explore independent and joint associations of HFI and HWI with functional disability in Ecuadorian adults.Design, setting, and participantsThis cross-sectional study used data from the 2018 Ecuadorian National Health and Nutrition Survey, a nationally representative, population-based survey conducted in Ecuador. The study included adults (aged 18-99 years) with information on sociodemographic characteristics, household food and water security, and functional disability status. Data were collected in 2 waves of the survey, from November 2018 to January 2019 and June to July 2019. Statistical analysis was performed from May to December 2024.ExposuresHFI, WFI, or both.Main outcomes and measuresThe primary outcome was self-reported functional disability, assessed using the Washington Group Short Set on Functioning, a tool that uses a set of 6 questions to measure activity limitations.ResultsAmong 42 071 participants (mean [SE] age, 48.0 [0.1] years; 31 683 male [75.3%]; 1840 African descendant [4.4%], 5184 Indigenous [12.3%], and 35 047 Mestizo ethnic majority group [83.3%]), most lived in urban areas (26 164 participants [62.2%]). Exposure to HFI only was associated with an increased risk for any functional disability (adjusted relative risk [aRR], 1.44; 95% CI, 1.37-1.52), as well as sensory (aRR, 1.43; 95% CI, 1.35-1.52), physical (aRR, 1.56, 95% CI, 1.42-1.72), and cognitive (aRR, 1.78; 95% CI, 1.61-1.98) disabilities. HWI exposure only was associated with increased risk for any functional disability (aRR, 1.12; 95% CI, 1.06-1.20), as well as sensory (aRR, 1.17; 95% CI, 1.09-1.25), physical (aRR, 1.15; 95% CI, 1.05-1.26), and cognitive (aRR, 1.17; 95% CI, 1.03-1.34) disabilities. Exposure to dual HFI and HWI was associated with a greater increase in risk than HFI or HWI alone of any functional disability (aRR, 1.61; 95% CI, 1.50-1.72), as well as sensory (aRR, 1.65; 95% CI, 1.52-1.79), physical (aRR, 1.72; 95% CI, 1.59-1.87), and cognitive (aRR, 2.01; 95% CI, 1.76-2.29) disabilities.Conclusion and relevanceIn this study, dual exposure to HFI and HWI was associated with a greater increase in risk of any and specific functional disabilities compared with independent contributions of HFI and HWI alone. These findings highlight the importance of addressing HFI and HWI jointly rather than independently when conducting research on disability and other health outcomes and in designing policies and programs to protect at-risk adults and their households.

Project description:ImportanceRacial and ethnic minority groups disproportionately experience food insecurity. During the COVID-19 pandemic, the US enacted temporary food assistance policies, including emergency allotments for Supplemental Nutrition Assistance Program (SNAP) benefits. The effects of the pandemic and these policies on food insecurity by race and ethnicity are unclear.ObjectiveTo examine prevalence trends in food insecurity by racial and ethnic groups and SNAP use before and during the pandemic.Design, setting, and participantsThis cross-sectional survey study analyzed National Health Interview Survey data before (January 2019 to March 2020) and during the COVID-19 pandemic (April 2020 to December 2022). Participants were noninstitutionalized US adults (≥18 years) with low income (<200% federal poverty level). Statistical analysis was performed from September 25, 2023, to February 27, 2024.ExposureCOVID-19 pandemic time period.Main outcomes and measuresFood insecurity was measured using the 10-item US Department of Agriculture Adult Food Security Survey module, categorizing participants as food secure (high or marginal food security) or insecure (low or very low food security). Survey-weighted Poisson regressions were modeled to examine changes in food insecurity prevalence over time by race and ethnicity (Asian, Black, Hispanic, and White) and by race and ethnicity and SNAP use (yes or no) including a 3-way interaction term (time × race and ethnicity × SNAP).ResultsAmong 30 396 adults with low income, approximately one-half were female (56.0% [95% CI, 54.7%-57.2%] during the pre-COVID-19 time period; 57.4% [95% CI, 56.4%-58.4%] during the COVID-19 time period). Food insecurity prevalence decreased from 20.9% (95% CI, 19.9%-22.0%) before the COVID-19 pandemic to 18.8% (95% CI, 17.9%-19.7%) during the pandemic (P < .001). SNAP use prevalence increased overall (from 31.5% [95% CI, 30.1%-32.9%] to 36.0% [95% CI, 34.8%-37.3%]; P < .001) and for each racial and ethnic group. There were no significant differences in food insecurity changes over time by racial and ethnic group (Wald test F = 1.29; P = .28 for 2-way interaction). Among SNAP participants, food insecurity decreased for Asian, Hispanic, and White adults but did not change for Black adults; among non-SNAP participants, food insecurity did not change for Black, Hispanic, and White adults but increased for Asian adults (Wald test F = 4.43; P = .02 for 3-way interaction).Conclusions and relevanceDuring the COVID-19 pandemic, food insecurity decreased among SNAP participants in most racial and ethnic groups but did not decrease among non-SNAP participants in any group. These results suggest that during the pandemic, increased SNAP benefit amounts were associated with ameliorating food insecurity for many US adults who were able to access SNAP but did not reduce racial and ethnic disparities in food insecurity.

Dataset Information

Physical Disability and Older Adults' Perceived Food and Economic Insecurity During the COVID-19 Pandemic.

Objectives

Method

Results

Discussion

Publications

Physical Disability and Older Adults' Perceived Food and Economic Insecurity During the COVID-19 Pandemic.

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