Online Program

Food insecurity among injection drug users in los angeles and san francisco

Monday, November 4, 2013

Jane Schmitz, PhD, Preventive Medicine, University of Southern California, Los Angeles, CA
Alex H. Kral, PhD, Urban Health Program, RTI International, San Francisco, CA
Daniel Chu, Preventive Medicine, University of Southern California, Los Angeles, CA
Lynn Wenger, MSW, MPH, Urban Health Program, RTI International, San Francisco, CA
Ricky N. Bluthenthal, PhD, Institute for Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, CA
Injection drug users (IDUs) likely experience a higher prevalence of food insecurity than the general adult population due to their risk environment. This study aimed to estimate the prevalence of food insecurity and identify demographic and behavioral risk factors. We recruited IDUs from Los Angeles (n=279) and San Francisco (n=273) using community outreach and targeted sampling between April 2011 and April 2012. Participants responded to questions about demographics, drug use, health status, sexual activity and a 10-item subset of the U.S. Department of Agriculture Food Security Questionnaire. Food insecurity was defined as affirmative answers to ≥3 items. Adjusted prevalence rate ratios (PRRs) were estimated using generalized linear models. The sample was predominately male, impoverished, and non-white. The prevalence of food insecurity was 50.5% overall, with similar estimates in each city. After excluding variables that were not associated with food insecurity in bivariate or fully adjusted models, seven variables were significantly associated with food insecurity. Compared to their peers who were food secure, food insecure IDUs were more likely to be homeless (PRR 1.28; 95% Confidence Interval 1.06-1.56), report recycling as an income source (1.22; 1.02-1.46), engage in risky needle sharing (1.45; 1.19-1.77) and acquisition (1.50; 1.17-1.94) practices, have been injected by others (1.25; 1.05-1.48), be HIV positive (1.41; 1.08-1.84) and feel at risk for arrest (1.25; 1.05-1.46). The level of food insecurity is exceptionally high among all identified IDU subgroups. Coordinated efforts are required to improve food security among IDUs, irrespective of additional risk factors.

Learning Areas:

Advocacy for health and health education
Program planning

Learning Objectives:
Describe the prevalence of food insecurity in a population of injection drug users living in San Francisco and Los Angeles. Analyze risk factors for food insecurity in the studied population. Compare the prevalence of food insecurity with other IDU and marginal populations in North America and discuss possible future directions for policy and practice.

Keyword(s): Drug Injectors, Food Security

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: In addition to my doctoral degree in international health and nutrition, I have several years of experience researching nutritional status and evaluating interventions to improve nutritional status in low-income populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.