Competing needs: An exploration of major illness as a predictor of rising rates of food insecurity.

摘要

The prevalence of household food insecurity is the highest it's ever been since nationally representative food security surveys were first conducted in 1995 (Household Food Security in the United States, 2008). The cost of health care has been rising at a much faster rate than the growth in national income (Health Care Costs and Election 2008, Kaiser Family Foundation). More Americans are exposed to health care costs through either lack of health insurance, steeper deductibles, higher premiums, or bigger copayments. The parallel increase in healthcare costs and food insecurity indicates a possible relationship between these two factors. The primary focus was to explore the association between food insecurity and different aspects of financial events resulting from ill health. Key findings include: (1) Large out-of-pocket medical expenses and lost time from work due to illness or injury are significantly associated with increased food insecurity, but only when these events occur in the last six months of a household's measured food security status. This suggests households that experience these events have a heightened risk of increased food insecurity, but that this risk is temporary. (2) Avoiding obtaining healthcare due to cost is significantly associated with increased food insecurity in the last six months of a household's measured food security, as well as the previous twelve months before that. Both anxiety regarding cost of medical care, as well as the expectancy that there will be a dire need for future medical care, could affect how much money a household spends on food. (3) An inability to borrow money from family or friends to pay for medical expenses or other unexpected costs, and financial responsibility for children outside the home, are also associated with a higher risk of increased food insecurity. These findings have critical implications for both research and policy relating to food insecurity and healthcare, which are discussed in the conclusion.