Self-Reported Vision Impairment and Food Insecurity in the US: National Health Interview Survey, 2011–2018

ABSTRACT

Purpose

To determine if vision impairment (VI) is associated with food insecurity among the United States (US) adults.

Methods

This is a cross-sectional study of US adults ≥18 years below a threshold of 150% poverty from the National Health Interview Survey (NHIS), years 2011–2018. Outcome measures included food insecurity status, based on response to the NHIS adult (10-item) food insecurity tool, either as a binary (food secure or insecure) or ordinal (high, marginal, low, and very low) variable. VI was defined as self-reported trouble seeing, even when wearing glasses or contact lenses. Multivariable logistic regression analyses adjusted for potential confounders examined associations between VI and food insecurity.

Results

Participants (N = 62075) were majority female (57%), White (62%), and non-Hispanic (74%). Of them, 16% reported VI and 28% were food insecure. In fully adjusted logistic regression models, adults with VI had 216% higher odds (95% CI = 2.01–2.31) of being food insecure than adults without VI. Further, there was a dose–response relationship between VI and food insecurity noted in a multinomial model: VI predicted 159% higher risk of marginal food security (95% CI = 1.44–1.75), 197% higher risk of low food security (95% CI = 1.80–2.16), and 295% higher risk of very low food security (95% CI = 2.69–3.22), as compared to high food security.

Conclusion

VI is associated with food insecurity, increasingly so among adults with highest levels of food insecurity in this national sample of low-income US adults. This data highlights the need for targeted interventions to address and reduce the burden of food insecurity among US adults with VI.

KEYWORDS:

• vision impairment
• food insecurity
• low income adults

Disclosure statement

None of the following authors have any proprietary interests or conflicts of interest related to this submission: Priyanka Kumar, Jessica Brinson, Jiangxia Wang, Laura Samuel, Bonnielin K. Swenor, Adrienne W. Scott, Varshini Varadaraj. This submission has not been published anywhere previously and is not simultaneously being considered for any other publication. This work was previously submitted to JAMA Ophthalmology, where they were unsure about the validity of self-reported data surrounding visual impairment; in keeping with a disability perspective, we have remained inclusive with our study criteria to include all adults with self-reported trouble seeing in this study. This work was also submitted to JAMA Network Open, where the subject matter was deemed to not meet their current editorial priorities.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.