Relationship between food insecurity and obesity among people with disabilities in Oregon

Background: Risk for food insecurity, the limited or uncertain availability of nutritionally adequate and safe food, is increased for people with disabilities (PWD). Food insecurity is associated with poor nutritional status and health problems. Increased obesity risk is also described for PWD. Obesity has been associated with food insecurity, but this relationship varies with population demographics such as sex and ethnicity. It is not known how food insecurity relates to obesity risk for PWD. This study investigates the relationship between food insecurity and obesity for PWD. Methods: A cross-sectional study using 2005 Oregon Behavioral Risk Factor Surveillance System (BRFSS) data addresses this question. BRFSS, a population-based telephone survey, provides information on health status and behaviors. Participants >17 years with complete data were included (n=15027). Disability status was based on BRFSS core disability questions. Food insecurity was categorized using the US Core food security module. Multivariate logistic regression was carried out to assess the relationship between food insecurity and obesity (BMI>=30kg/m2) for PWD compared to those without. Analyses were carried out using SUDAAN. Results: Most participants (83.5%) were of non-Hispanic White race/ethnicity and 3.7% were Hispanic. Disability was reported by 24.7%. Food insecurity and obesity were more prevalent for PWD (23.1% and 34.1%) vs. others (13.3% and 20.2%). Food insecurity (OR=1.43, p<.05) and disability (OR=1.84, p<.05) predicted increased obesity risk. The interaction of food insecurity and disability was not significant. Conclusions: Increased prevalence of food insecurity and overweight indicates need for strategies to promote food security and healthy weight for PWD.