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Perry TT, Grant TL, Dantzer JA, Udemgba C, Jefferson AA. Impact of socioeconomic factors on allergic diseases. J Allergy Clin Immunol 2024; 153:368-377. [PMID: 37967769 PMCID: PMC10922531 DOI: 10.1016/j.jaci.2023.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/13/2023] [Accepted: 10/25/2023] [Indexed: 11/17/2023]
Abstract
Allergic and immunologic conditions, including asthma, food allergy, atopic dermatitis, and allergic rhinitis, are among the most common chronic conditions in children and adolescents that often last into adulthood. Although rare, inborn errors of immunity are life-altering and potentially fatal if unrecognized or untreated. Thus, allergic and immunologic conditions are both medical and public health issues that are profoundly affected by socioeconomic factors. Recently, studies have highlighted societal issues to evaluate factors at multiple levels that contribute to health inequities and the potential steps toward closing those gaps. Socioeconomic disparities can influence all aspects of care, including health care access and quality, diagnosis, management, education, and disease prevalence and outcomes. Ongoing research, engagement, and deliberate investment of resources by relevant stakeholders and advocacy approaches are needed to identify and address the impact of socioeconomics on health care disparities and outcomes among patients with allergic and immunologic diseases.
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Affiliation(s)
- Tamara T Perry
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark.
| | - Torie L Grant
- Johns Hopkins University School of Medicine, Baltimore, Md
| | | | - Chioma Udemgba
- National Institute of Allergic and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Akilah A Jefferson
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
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2
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Ni K, Wan Y, Zheng Y. Association between adult food insecurity and self-reported asthma in the United States: NHANES 2003-2018. J Asthma 2023; 60:2074-2082. [PMID: 37255268 DOI: 10.1080/02770903.2023.2214921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/22/2023] [Accepted: 05/13/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Asthma is a chronic disease of the lungs. The development of asthma is related to various risk factors. Food insecurity is a critical social determinant of health, although there is little information on the association between adult food insecurity and asthma. The purpose of this study is to explore the potential correlation in US adults. METHODS The study population data were extracted from NHANES 2003-2018. Food insecurity was measured using the USDA FSSM and categorized as full, marginal, low, or very low food security. The assessment of self-reported asthma was determined by self-report questionnaires. The self-reported positive outcomes were that participants had asthma and a history of asthma attacks and asthma-related ER visits in the past year. We developed two multivariate logistic regression models. Stratified analyses were performed by gender and age. RESULTS A total of 38,077 participants were considered in our final analysis. Compared to participants with FFS, the ORs (95% CIs) for asthma were 1.16 (1.00-1.33), 1.42 (1.23-1.64), and 1.56 (1.34-1.80) for participants with MFS, LFS, and VLFS, respectively (Model II). Additionally, after full adjustment, individuals with VLFS had 49% greater risks of asthma attacks (OR = 1.49; 95% CI 1.13-1.97). The ORs (95% CIs) for asthma-related ER visits were 1.59 (1.14-2.23) and 1.98 (1.36-2.87) for participants with LFS and VLFS, respectively (Model II). The positive correlations remained robust when stratified by gender and age. CONCLUSION Our research showed that food insecurity among US adults was associated with asthma, asthma attacks, and asthma-related ER visits.
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Affiliation(s)
- Kejie Ni
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China
| | - Yufeng Wan
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China
| | - Yulong Zheng
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China
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Grande M, Eldeirawi KM, Huntington-Moskos L, Polivka B, Nyenhuis SM. The Association of Food Insecurity With Asthma Control in Adults During COVID-19. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2144-2149. [PMID: 37146886 PMCID: PMC10845761 DOI: 10.1016/j.jaip.2023.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/16/2023] [Accepted: 04/10/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Food insecurity has been associated with poorer asthma control in children, but research lacks in adults. OBJECTIVE To assess the frequency of food insecurity and its association with asthma control in adults during the coronavirus disease 2019 pandemic. METHODS An online cross-sectional survey study was conducted in US adults with asthma. Survey questions included how worried or concerned participants were about food security since the pandemic. Asthma control was assessed using the Asthma Control Test, with uncontrolled asthma defined as Asthma Control Test score less than or equal to 19. Self-report of food insecurity since the pandemic was assessed. Food insecurity variables were dichotomized into high insecurity (≥3) or low insecurity (<3). Descriptive statistics and bivariate analyses were performed. RESULTS Of the total participants (N = 866), 82.79% were female; mean age of participants was 44 ± 15.05 years, their mean Asthma Control Test score was 19.25 ± 4.54, and 18.48% had high food insecurity. Participants with high food insecurity were more likely to have uncontrolled asthma (74.38%) compared with those with lower food insecurity (34.99%; P < .01). The relationship between asthma control and food insecurity remained significant after adjusting for age, education, sex, race, anxiety, and living stability concerns due to the pandemic. CONCLUSIONS Food insecurity exists in adults with asthma and is associated with uncontrolled asthma. Providers should consider screening their patients for food insecurity when treating individuals with uncontrolled asthma.
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Affiliation(s)
- Matthew Grande
- College of Medicine, University of Illinois, Chicago, Ill
| | - Kamal M Eldeirawi
- Department of Population Health Nursing Science, University of Illinois, Chicago, Ill
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Sohrabi M, Mollanoroozy E, Abbasi H, Mehrabadi S, Zamani F, Ajdarkosh H, Hatamian S, Bahavar A, Safarnezhad Tameshkel F, Gholami A. Household Food Insecurity and Associated Factors among Iranian Patients with Esophageal and Gastric Cancers. Middle East J Dig Dis 2023; 15:76-82. [PMID: 37546504 PMCID: PMC10404090 DOI: 10.34172/mejdd.2023.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/07/2023] [Indexed: 08/08/2023] Open
Abstract
Background: Household food insecurity (HFI) which has still been one of the major global public health issues is related to adverse health outcomes in individuals. Therefore, this study aimed to determine the prevalence of HFI and its associated factors in Iranian patients with esophageal and gastric cancers. Methods: The data of this cross-sectional study was obtained from 315 patients with esophageal and gastric cancers who were selected from a gastrointestinal cancer-based cohort study conducted in Firoozgar hospital, in Tehran. Food insecurity (FI) was measured using the Iranian version of the HFI questionnaire that was completed by a trained interviewer. The multivariable logistic regression model was used to determine the independent association of each factor with HFI. A P value lower than 0.05 was considered statistically significant. Results: The mean±SD of participants' age was 63.2±12.6 years and 65.4% were men. Most of the patients (75.8%) suffered from gastric cancer and 24.2% from esophageal cancer. The overall prevalence of FI among participants' households was 35.2%. There was an independent significant association between wealth index (WI) and HFI after the use of the multivariable logistic regression model, in such a way that the odds of FI in the poorest, poor, moderate, and rich patients' households were respectively, 6.41, 5.05, 2.74 and 2.04 times higher compared with the richest households. Conclusion: More than a third of participants' households struggled with FI, which was found to have a higher prevalence in loweconomic households. Therefore, health policymakers should intervene in food-insecure households by developing, establishing, and implementing strategies and control programs to improve affordable food access.
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Affiliation(s)
- Masoudreza Sohrabi
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ensiyeh Mollanoroozy
- Epidemiology & Biostatistics Department, School of Public Health, Neyshabur University of Medical, Sciences, Neyshabur, Iran
| | - Hamid Abbasi
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Shima Mehrabadi
- Student Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ajdarkosh
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sare Hatamian
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Atefeh Bahavar
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Safarnezhad Tameshkel
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Epidemiology & Biostatistics Department, School of Public Health, Neyshabur University of Medical, Sciences, Neyshabur, Iran
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Smith L, Shin JI, Jacob L, López Sánchez GF, Schuch F, Tully MA, Oh H, Veronese N, Soysal P, Butler L, Barnett Y, Koyanagi A. Food insecurity and physical multimorbidity among adults aged ≥ 50 years from six low- and middle-income countries. Eur J Nutr 2023; 62:489-497. [PMID: 36129530 PMCID: PMC9491254 DOI: 10.1007/s00394-022-02999-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/31/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Food insecurity and multimoribidity (i.e., ≥ 2 chronic conditions) may be linked bidirectionally, but there are no studies on this topic from LMICs. Therefore, the aim of the present study was to examine the association between food insecurity and physical multimorbidity in a large representative sample of older adults from six LMICs. METHODS Cross-sectional, community-based data on adults aged ≥ 50 years from the World Health Organization's Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa were analyzed. A total of 11 chronic physical conditions were assessed. Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the associations. RESULTS Data on 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50-114 years; 47.9% males] were analyzed. After adjustment for potential confounders, in the overall sample, compared to being food secure, moderate and severe food insecurity were associated with 1.29 (95% CI 1.06-1.56) and 1.56 (95% CI 1.13-2.16) times higher odds for multimorbidity, respectively CONCLUSION: Food insecurity was associated with greater odds for multimorbidity in older adults from LMICs. Addressing food insecurity in the general population may reduce risk for multimorbidity, while screening for food insecurity and addressing it among those with multimorbidity may lead to better clinical outcomes, pending future longitudinal research.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03372, Korea
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Barcelona, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000, Versailles, France
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey, BT15 1ED, Northern Ireland
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, 90007, USA
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, 90133, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - Laurie Butler
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Barcelona, Spain
- ICREA, Pg, Lluis Companys 23, 08010, Barcelona, Spain
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Food insecurity arises the likelihood of hospitalization in patients with COVID-19. Sci Rep 2021; 11:20072. [PMID: 34625638 PMCID: PMC8501085 DOI: 10.1038/s41598-021-99610-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 09/28/2021] [Indexed: 01/08/2023] Open
Abstract
The World Health Organization (WHO) has declared the Corona pandemic as a public health emergency. This pandemic affects the main pillars of food security. This study aimed to investigate the relationship between food insecurity and the probability of hospitalization and the length of the recovery period after getting COVID-19. The cross-sectional study was performed through the census on COVID-19 patients diagnosed in Fasa, Iran. Informed consent, demographic, and food security questionnaire were completed over the phone. Then, all patients were followed up until recovery. Data were analyzed using SPSS26 and Chi-square test, t-test, and logistic regression (P < 0.05). In this study, 219 COVID-19 patients [100 (54.7%) male and 119 (54.3%) female] with a mean age of 40.05 ± 15.54 years old were examined. Possibility of hospitalization and the length of the recovery period of more than one month was significantly longer in the food-insecure group (P = 0.001) and (P = 0.37), respectively, but the mean length of hospital stay in the two groups was not significantly different (P = 0.76). After adjusting for all confounding variables, people with food insecurity were 3.9 times more likely to be hospitalized than those with food security. Overall, we observed that food-insecure people were significantly more likely to be hospitalized than the secure group.
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Bae JH, Choi JH. Gender disparities in childhood obesity and household food insecurity. Nutrition 2021; 87-88:111190. [PMID: 33773405 DOI: 10.1016/j.nut.2021.111190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Childhood obesity is a critical health issue. The etiology of childhood obesity is multifactorial, with age, gender, race/ethnicity, and socioeconomic status interacting to affect risk. Food insecurity is known to be associated with risk of childhood obesity, but the body of evidence regarding Koreans is lacking. This study investigated the association between childhood obesity and household food insecurity in Koreans. Other lifestyle and nutritional factors associated with obesity were also examined. METHODS Using data from the Korean National Health and Nutrition Examination Survey, a cross-sectional study was conducted with 1527 boys and 1366 girls. A comparison of general characteristics and nutritional intake between the groups was made using Student's t tests, χ2 tests, and general linear models. The association between childhood obesity and food insecurity was estimated with logistic regression models, and presented with odds ratios and 95% confidence intervals either with or without covariates. RESULTS Boys who were obese dined out less frequently and engaged less in regular exercise, but no differences in nutrition intake were observed between children who were and were not obese. Girls who were obese were less likely to have a caregiver and consumed a higher percentage of energy from protein. Boys experiencing household food insecurity were less likely to be obese (adjusted odds ratio, 0.25; 95% confidence interval, 0.06-0.99), but girls with food insecurity were at three times higher risk of obesity (adjusted odds ratio, 3.00; 95% confidence interval, 1.23-7.31). CONCLUSIONS Differential lifestyle factors are associated with obesity phenotypes in boys and girls. Food insecurity also showed a contrasting association with obesity risk by gender in young Koreans.
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Affiliation(s)
- Ji-Hyun Bae
- Department of Food Science and Nutrition, Keimyung University, Daegu, Korea
| | - Jeong-Hwa Choi
- Department of Food Science and Nutrition, Keimyung University, Daegu, Korea.
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Kim EK, Ju SY. Asthma and Dietary Intake of Fish, Seaweeds, and Fatty Acids in Korean Adults. Nutrients 2019; 11:nu11092187. [PMID: 31514397 PMCID: PMC6769730 DOI: 10.3390/nu11092187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/05/2019] [Accepted: 09/07/2019] [Indexed: 12/13/2022] Open
Abstract
The dietary intake of fish and fatty acid may influence the risk of asthma, yet epidemiological research remains controversial and inconclusive. We examined the association between asthma and the dietary intake of fish, seaweeds, and fat in a Korean population, aged 19 to 64 years, using the data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2016 (n = 13,038). The prevalence of doctor-diagnosed asthma and medication prescribed asthma were 2.5% and 1.0%, respectively. The subjects with medication prescribed asthma had significantly lower consumption of seaweeds (p = 0.0110) and lower n3/n6 polyunsaturated fatty acid (PUFA) (p = 0.0275) as compared to subjects without medication prescribed asthma. Multiple logistic regression analysis showed that the odds ratio (OR) (95% confidence interval, CI) of doctor-diagnosed asthma in the highest quartile were 0.63 (0.41-0.97) and 0.66 (0.44-1.00) for fish and seaweeds respectively, compared to the lowest quartile after adjusting confounding factors. Furthermore, there were significant inverse associations between medication prescribed asthma and seaweeds [OR (95% CI) = 0.37 (0.19-0.70)], n-3 PUFA [OR (95% CI) = 0.43 (0.21-0.89)] and n3/n6 [OR (95% CI) = 0.47 (0.22-0.99)] intake after adjusting for confounding factors. These results suggest, that the higher consumption of fish and seaweed and the high ratio of n-3 to n-6 PUFA may be associated with a lower prevalence of asthma.
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Affiliation(s)
- Eun-Kyung Kim
- Major in Food Science, College of Biomedical and Health Science, Konkuk University, Chungju, Chungbuk 27478, Korea
| | - Se-Young Ju
- Major in Food Science, College of Biomedical and Health Science, Konkuk University, Chungju, Chungbuk 27478, Korea.
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