The association between food insecurity and health behavior outcomes
Type of DegreeDissertation
Nutrition and Food Science
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The purpose of this dissertation is to provide a better understanding of the health and behavior status of food insecure persons in the United States. This dissertation covers three studies which used data from the National Health and Nutrition Examination Surveys 1999-2010. The first study examined the associations between adult food security status and sleep duration, sleep latency, and sleep complaints reported to a health care professional. This study included 5,637 men and 5,264 women (≥ 22 y) who participated in the NHANES 2005-2010. The results showed that very low food secure women reported significantly shorter sleep duration than fully food secure women (P<0.01). Among men those who were marginally food secure, low food secure, and very low food secure reported significantly longer sleep latency than fully food secure men (P<0.05), but no association regarding sleep latency was observed among women. Among both men and women, marginally food secure, low food secure, and very low food secure participants were more likely to report sleep complaints than their fully food secure counterparts (P<0.05). The second study determined whether the association between food insecurity and asthma is moderated by recent tobacco exposure among children. Our population-based sample included 15417 participants in the National Health and Nutrition Examination Survey 1999-2010. The results showed that among children without recent tobacco exposure, those who were living in food insecure (Odds Ratio 1.42; 95% CI, 1.05-1.93) households were more likely to report asthma compared to those in fully food secure households. Among children with recent tobacco exposure, an association between food insecurity and asthma was not observed. The third study estimated the misclassification of young-age children’s tobacco exposure and its association with socioeconomic characteristics, including children’s sex, age, race/ethnicity, family income, numbers of household rooms, and household food security status. Our population-based sample included 6328 participants (3-10y) in the National Health and Nutrition Examination Survey 1999-2010. The results showed that children who were younger (Adjusted OR 1.38, 95% CI 1.16-1.64), Non-Hispanic Black (Adjusted OR 1.38, 95% CI 1.16-1.64), living in low PIR families (Adjusted OR 1.38, 95% CI 1.10-1.71), and living in smaller housing (Adjusted OR 1.50, 95% CI 1.21-1.87) were more likely to be misclassified of tobacco exposure than their counterparts. In the crude model, children living in food insecure household were more likely to be misclassified of tobacco exposure than those living in food secure household (OR 1.27, 95% CI 1.04-1.55), but the association was attenuated after other characteristics taken into account in the full model. Sex was not found to be associated with misclassification of tobacco exposure. These results indicated the adverse health and behavior outcomes of food insecure persons and suggested that public health efforts need to be increased to improve food security status in the United States.