Relationship of Household Food Insecurity to Health-Related Quality of Life in a Large Sample of Rural and Urban Women

Abstract

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.

KEYWORDS:

• African American
• mental health
• nutrition
• quality of life
• socioeconomic status
• food security
• rural

Notes

This research was supported in part with funding from the National Institutes of Health (NIH)/National Center on Minority Health and Health Disparities (# 5P20MD002295) and the Centers for Disease Control and Prevention (CDC), Prevention Research Centers Program, through the Center for Community Health Development (#1U48DP001924). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH and CDC. The authors declare that they have no conflicts of interest.

Notes. ¹Difference in frequencies between urban and rural participants calculated with cross-tabulations and χ² statistic;

²Statistically significant after using Bonferroni correction for multiple comparison (Bonferroni-corrected p = 0.004).

^aNonwhite includes black or African Americans (urban = 47, 11.2%; rural = 95, 10%), Hispanics (urban = 33, 7.9%; rural = 36, 3.8%), and other races (urban = 19, 4.5%; rural = 5.1%).

^bCut-off scores for components of Health-Related Quality of Life: Fair-to-poor general health = fair or poor vs. excellent, very good, or good; Poor physical health = 14 or more physically unhealthy days in the past 30 days; Frequent mental distress = 14 or more mentally unhealthy days in the past 30 days.

^c n = 1279 (urban = 404; rural = 875) due to missing data on healthy days of physical health.

^d n = 1290 (urban = 399; rural = 891) due to missing data on healthy days of mental health.

Notes. ^a ≥14 days where physical health was not good (n = 404 urban and 875 rural women).

^b≥14 days where mental health was not good (n = 399 urban and 891 rural women).

Note. ¹All variables entered simultaneously; model estimated with White-corrected standard errors.

Notes. ¹All variables entered simultaneously; model estimated with White-corrected standard errors.

^aNonwhite includes black or African Americans, Hispanics, and “other races.”

^bPoverty = ≤ 100% FPL; Low income = 101–199% FPL.

Notes. ¹All variables entered simultaneously; model estimated with White-corrected standard errors.

^aNonwhite includes black or African Americans, Hispanics, and “other races.”

^bPoverty = ≤ 100% FPL; Low income = 101–199% FPL.

Notes. ¹All variables entered simultaneously; model estimated with White-corrected standard errors.

^aNonwhite includes black or African Americans, Hispanics, and “other races.”

^bPoverty = ≤ 100% FPL; Low income = 101–199% FPL.