赚钱性 JAMA内科 这种负担突出显著粮食不安全的姿势,以医疗保险受益人。 粮食不安全 特别普遍为65岁以下人口中的年龄和医疗补助那些有双录取,低收入,慢性合并症,抑郁或焦虑的人。

Investigators abstracted data from the 2016 Medicare Current Beneficiary Survey, which was administered between July 25, 2016 and August 31, 2017. 调查内容包括中,参加6项粮食安全调查问卷认可WHO 2个或更多的项目被认为是“粮食不安全。” Health-related covariates were captured by self-report; demographic information was gathered using the Medicare & Medicaid Services administrative database. Analyses were stratified by age, with respondents younger than 65 years 和 those age 65 years or older considered separately. Logistic regression analyses were performed to calculate the odds of food insecurity among enrollee subgroups. 

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与不断扩招9674社区居住的成年人总医疗2016助长了分析数据。在小于65名参保,38.3%(95%置信区间[CI],34.5%-42.1%)报告粮食不安全。在ESTA目前粮食不安全有几个危险因素是常见的年龄组,收入,包括每年少于$ 15K或以上的慢性具有条件4,和抑郁症。在成人中65岁以上,9.1%(95%CI,8.3%-9.8%)报告粮食不安全,与观察到的是那些具备较高的利率 收入低于每年$ 15K (25.8%; 95% CI, 22.9%-28.7%) 和 Medicaid dual enrollment (33.6%; 95% CI, 30.5%-36.7%). Per multivariate logistic regression, the 3 lowest income brackets (<$15k; $15k-$25k; $25k-$50k) were each associated with food insecurity when compared with the highest bracket (>$50k). For individuals under 65 years, having an income less than $15k was associated with 8-fold higher odds of food insecurity compared with an income more than $50k (95% CI, 3.32-18.71). Among enrollees aged 65 years or older, the odds ratio [OR] of food insecurity for those earning less than $15k versus more than $50k was 12.88 (95% CI, 7.32-20.41). 粮食不安全 also was associated with having 4 or more chronic conditions (<65 years: OR, 2.07; 95% CI, 1.30-3.28; ≥65 years: OR, 1.91; 95% CI, 1.33-2.76); depression (<65 years: OR, 2.65; 95% CI, 1.75-4.00; ≥65 years: OR, 1.60; 95% CI, 1.19-2.15); or anxiety (<65 years: OR, 1.72; 95% CI, 1.20-2.47; ≥65 years: OR, 1.44; 95% CI, 1.02-2.04).

在用于单医疗条件构成二次模型,糖尿病用食品不安全的边界线显著关联相关联的(或,1.34; 95%CI,1.03-1.75)在登记者年龄在65岁或以上。在二次模型,补充保险分摊与雇主赞助保险,医疗补助仍然显着的年龄支架粮食不安全关联(或,3.80; 95%CI,2.20-6.56)。

医疗保险参保的显著报数几乎粮食不安全:1在65岁以下,1个在65岁的10岁以上4。对于粮食不安全的其他危险因素包括低收入医疗补助双录取,慢性疾病共病,抑郁和焦虑。由于该研究是一项横断面分析,因果关系不能成立。即便如此,这些数据强调的重要性“[加剧]注重健康的社会决定因素”,根据该研究的作者。这一目标的干预双重参保和个人与其他危险因素可能是减少粮食不安全的负担是必不可少的。

参考

赚钱性 赚钱性 [在线发表于2019年9月30日。 JAMA内科杂志。 DOI:10.1001 / jamainternmed.2019.3900