Abstract Body: Introduction:
Food insecurity (FI), defined as the limited or uncertain availability of nutritionally adequate and safe foods, is a major public health issue in the Caribbean and worldwide. Estimates show that 41% of Caribbean households experience FI, which has been linked to poor cardiovascular health. Yet, little research exists to understand factors that contribute to high FI prevalence in the region that experiences a high cardiovascular disease burden.
Hypothesis:
Sex, age, socioeconomic position, and comorbidities are associated with FI.
Methods:
We analyzed data from the Addressing Blood Pressure Control Through Dietary Approaches (ABCD) Study, a cross-sectional study that examined the effects of food insecurity on hypertension control in Kingston, Jamaica. Patients were recruited from two chronic disease clinics. Consenting participants completed an interviewer-administered questionnaire including the Latin American and Caribbean Food Insecurity Scale (ELCSA), demographics, social and clinical characteristics, and lifestyle behaviors questions. ELCSA scores ranged from 0-9, categorizing patients as 0 food secure, 1-3 mild FI, and ≥4 moderate/severe FI. Chi-square tests and multinomial logistic regression identified factors associated with FI.
Results:
The final sample included 252 patients with complete study variables. Results showed that 77% of patients had FI and that younger patients were more likely to have FI (p=0.02). There were no statistically significant differences in FI according to sex, marital status, educational attainment, and employment. Multinomial logistic regression model results showed perceptions of the food environment as affordable, and the number of people living in a household were significantly associated with FI. Patients who lived in households with 5-7 people had 6 times greater odds of severe FI (vs. food secure) (CI=1.72-18.46) than those who lived in households with up to four people. Those who perceived their food environment as affordable had 86 percent lower odds (OR=.143, CI=0.06-0.37) of moderate/severe FI compared to patients who perceived their food environment as rarely/never or sometimes affordable.
Conclusion:
Study findings show a high prevalence of FI among hypertensive patients in Kingston, Jamaica. Findings vary in consistency with existing research on contributing factors to FI and suggest the need for structural interventions to reduce FI in Jamaica.