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      Impact of Housing Instability and Social Risk Factors on Food Insecurity Among Vulnerable Residents in San Diego County

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          Abstract

          To analyze the impact of housing instability and social risk facts on food insecurity using resource center client information. We utilized 2-1-1 San Diego’s client database to analyze the association of food insecurity and housing instability among residents from August 2017 to March 2020. 3468 clients had food or housing needs assessed by a risk rating scale. A multiple logistic regression model analyzed the associations between food insecurity and social risk factors including housing, transportation, utility bills, criminal justice, and medical debt. Multiple logistic regression indicates that those with housing instability encounter significantly greater risk of food insecurity (AOR 1.2) for homeless-sheltered, (AOR 2.1) for homeless-unsheltered. Also, utility needs (AOR 1.2) is significantly associated with food insecurity. However, those with medical debt are 48% less likely to have food insecurity. Approximately 77% of clients experienced food insecurity. Those with food insecurity also experienced higher needs in housing and other social risk factors. By further researching the association of food insecurity, housing instability, and other social needs in a population, we can better inform public health strategies that focus on proactive community and resource planning.

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          Most cited references 13

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          Housing instability and food insecurity as barriers to health care among low-income Americans.

          Homelessness and hunger are associated with poor health outcomes. Housing instability and food insecurity describe less severe problems securing housing and food. To determine the association between housing instability and food insecurity and access to ambulatory health care and rates of acute health care utilization. Secondary data analysis of the National Survey of American Families. 16,651 low-income adults. Self-reported measures of past-year access: (1) not having a usual source of care, (2) postponing needed medical care, or (3) postponing medication; and past-year utilization: (1) not having an ambulatory care visit, (2) having emergency department (ED) visits, or (3) inpatient hospitalization. 23.6% of subjects had housing instability and 42.7% had food insecurity. In multivariate logistic regression models, housing instability was independently associated with not having a usual source of care (adjusted odds ratio [AOR] 1.31, 95% confidence interval [CI] 1.08 to 1.59), postponing needed medical care (AOR 1.84, 95% CI 1.46 to 2.31) and postponing medications (AOR 2.16, 95% CI 1.70 to 2.74), increased ED use (AOR: 1.43, 95% CI 1.20 to 1.70), and hospitalizations (AOR 1.30, 95% CI 1.01 to 1.67). Food insecurity was independently associated with postponing needed medical care (AOR 1.74, 95% CI 1.38 to 2.21) and postponing medications (AOR 2.15, 95% CI 1.62 to 2.85), increased ED use (AOR 1.39, 95% CI 1.17 to 1.66), and hospitalizations (AOR 1.42, 95% CI 1.09 to 1.85). Housing instability and food insecurity are associated with poor access to ambulatory care and high rates of acute care. These competing life demands may lead to delays in seeking care and predispose to acute care.
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            Measuring household food insecurity: why it's so important and yet so difficult to do.

            Food insecurity is a daily reality for hundreds of millions of people around the world. Although its most extreme manifestations are often obvious, many other households facing constraints in their access to food are less identifiable. Operational agencies lack a method for differentiating households at varying degrees of food insecurity in order to target and evaluate their interventions. This chapter provides an overview of a set of papers associated with a research initiative that seeks to identify more precise, yet simple, measures of household food insecurity. The overview highlights three main conceptual developments associated with practical approaches to measuring constraints in access to food: 1) a shift from using measures of food availability and utilization to measuring "inadequate access"; 2) a shift from a focus on objective to subjective measures; and 3) a growing emphasis on fundamental measurement as opposed to reliance on distal, proxy measures. Further research is needed regarding 1) how well measures of household food insecurity designed for chronically food-insecure contexts capture the processes leading to, and experience of, acute food insecurity, 2) the impact of short-term shocks, such as major floods or earthquake, on household behaviors that determine responses to food security questions, 3) better measurement of the interaction between severity and frequency of household food insecurity behaviors, and 4) the determination of whether an individual's response to survey questions can be representative of the food insecurity experiences of all members of the household.
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              The Food Stamp Program and Food Insufficiency

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                Author and article information

                Contributors
                yrleila@gmail.com
                Journal
                J Community Health
                J Community Health
                Journal of Community Health
                Springer US (New York )
                0094-5145
                1573-3610
                8 May 2021
                : 1-8
                Affiliations
                [1 ]2-1-1 San Diego, Research and Data Analyst, 3860 Calle Fortunada, San Diego, CA 92123 USA
                [2 ]GRID grid.263081.e, ISNI 0000 0001 0790 1491, San Diego State University, ; 5500 Campanile Dr, San Diego, CA 92182 USA
                Article
                999
                10.1007/s10900-021-00999-w
                8105696
                33963985
                © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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