Incremental health care costs associated with food insecurity and chronic conditions among older adults

Abstract

Introduction The prevalence of food insecurity and chronic health conditions among older adults is a public health concern. However, little is known about associated health care costs. We estimated the incremental health care costs of food insecurity and selected chronic health conditions among older adults, defined as adults aged 50 or older. Methods We analyzed 4 years of data (2011-2014) from the National Health Interview Survey and 3 years of data (2013-2015) from the Medical Expenditure Panel Survey; we used 2-part models to estimate the incremental health care costs associated with food insecurity and 9 chronic conditions (hypertension, coronary heart disease, stroke, emphysema, asthma, cancer, chronic bronchitis, arthritis, and diabetes) among older adults. Results Approximately 14% of older adult respondents (n = 2,150) reported being food insecure. The 3 most common chronic conditions were the same for both food-insecure and food-secure older adults: hypertension, arthritis, and diabetes. The adjusted annual incremental health care costs resulting from food insecurity among older adults were higher in the presence of hypertension, stroke, and arthritis (P ≤ .05) and in the presence of diabetes (P ≤ .10). These findings were also true for the incremental health care costs resulting from food insecurity in the absence of these specific chronic conditions. Conclusion Our findings show that food insecurity interacts with chronic conditions. We observed higher health care costs in the presence of this interaction for those who were food insecure and had poor health than for those who were food secure.