OBJECTIVES:
To assess the prevalence of household food insecurity (HFI) and Supplemental
Nutrition Assistance Program (SNAP) participation in youth and young adults (YYA)
with diabetes overall, by type, and sociodemographic characteristics.
RESEARCH DESIGN AND
METHODS: The study included participants with youth-onset type 1
diabetes and type 2 diabetes from the SEARCH for Diabetes in Youth study. HFI
was assessed using the 18-item U.S. Household Food Security Survey Module (HFSSM)
administered from 2016-2019; ³3 affirmations on the HFSSM were considered indicative
of HFI. Participants were asked about SNAP participation. Chi-square tests were
used to assess whether the prevalence of HFI and SNAP participation differed by
diabetes type. Multivariable logistic regression
models were used to examine differences in HFI by participant characteristics.
RESULTS: Of 2561
respondents (age range 10-35 years; 79.6% ≤ 25 years), 2177 had type 1 diabetes
(mean age 21.0 years, 71.8% non-Hispanic white, 11.8% non-Hispanic black, 13.3%
Hispanic, 3.1% other) and 384 had type 2 diabetes (mean age 24.7 years, 18.8%
non-Hispanic white, 45.8% non-Hispanic black, 23.7% Hispanic, 18.7% other). The
overall prevalence of HFI was 19.7% (95% CI 18.1, 21.2). HFI was more prevalent
in type 2 diabetes than type 1 diabetes (30.7% vs. 17.7%, p< 0.01). In
multivariable regression models, YYA on Medicaid/Medicare or without insurance,
with lower parental education, and with lower household income had greater odds
of experiencing HFI. SNAP participation was 14.1% (95% CI 12.7, 15.5) with
higher participation among those with type 2 diabetes compared to type 1
diabetes (34.8% vs. 10.7%; p<0.001).
CONCLUSIONS: Almost 1
in 3 YYA with type 2 diabetes and more than 1 in 6 with type 1 diabetes reported
HFI in the past year, a significantly higher prevalence than the general U.S.
population.
Funding
SEARCH 4 The SEARCH for Diabetes in Youth Cohort Study (1R01DK127208-01, 1UC4DK108173) is funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases and supported by the Centers for Disease Control and Prevention. The Population Based Registry of Diabetes in Youth Study (1U18DP006131, U18DP006133, U18DP006134, U18DP006136, U18DP006138, U18DP006139) is funded by the Centers for Disease Control and Prevention (DP-15-002) and supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. SEARCH 1-3: SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention (PA numbers 00097, DP-05-069, and DP-10-001) and supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Kaiser Permanente Southern California (U48/CCU919219, U01 DP000246, and U18DP002714), University of Colorado Denver (U48/CCU819241-3, U01 DP000247, and U18DP000247-06A1), Cincinnati's Children's Hospital Medical Center (U48/CCU519239, U01 DP000248, and 1U18DP002709), University of North Carolina at Chapel Hill (U48/CCU419249, U01 DP000254, and U18DP002708), Seattle Children's Hospital (U58/CCU019235-4, U01 DP000244, and U18DP002710-01] and Wake Forest University School of Medicine (U48/CCU919219, U01 DP000250, and 200-2010-35171). SEARCH Food Security Cohort Study: The “Impact of disparities in food security on glycemic control and health care utilization among youth and young adults with diabetes” is funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK11746). Investigator Support: Dr. Faisal Malik’s time was supported by a K23 Career Development Award from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (DK119465).
