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. 2022 Jul;41(7):1045-1052.
doi: 10.1377/hlthaff.2021.01744.

Food Insecurity, Missed Workdays, And Hospitalizations Among Working-Age US Adults With Diabetes

Joshua M Weinstein  1 , Anna R Kahkoska  2 , Seth A Berkowitz  3
Affiliations

Food Insecurity, Missed Workdays, And Hospitalizations Among Working-Age US Adults With Diabetes

Joshua M Weinstein et al. Health Aff (Millwood). 2022 Jul.

Abstract

Food insecurity is associated with poor clinical outcomes among adults with diabetes, but associations with nonclinical outcomes, such as missed work, have not been well characterized. Our objective was to assess the associations between food insecurity, health-related missed workdays, and overnight hospitalizations. We pooled National Health Interview Survey data from the period 2011-18 to analyze food insecurity among 13,116 US adults ages 18-65 who had diabetes. Experiencing food insecurity, compared with being food secure, was associated with increased odds of reporting any health-related missed workdays, more than twice the rate of health-related missed workdays, and increased odds of overnight hospitalization within the prior twelve months. There was no significant association between food insecurity and the number of nights spent hospitalized. These findings underscore the broad impacts of food insecurity on health and wellness for working-age adults with diabetes. When weighing the costs and benefits of proposed interventions to address food insecurity, policy makers should consider potential benefits related to productivity in addition to implications for health care use.

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Figures

EXHIBIT 3
EXHIBIT 3
Predicted probability of health-related missed workdays and overnight hospitalizations among working-age adults with diabetes by food security status, 2011 – 2018 SOURCE: Authors’ analysis of National Health Interview Survey (NHIS) data, including the NHIS Survey Family Food Security Supplement, 2011 – 2018. NOTES: Households responding affirmatively to 3 or more of the 10 questions on the Supplement about food security over the previous 30 days were categorized as food insecure and otherwise as food secure. The main NHIS questionnaire asked respondents about health-related missed workdays and overnight hospitalizations over the previous 12 months. Predicted probabilities were calculated via predictive margins (i.e. recycled predictions), a method to calculate the marginal effects in non-linear models by varying the characteristic of interest across all observations in the data and averaging the predictions.(52)
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