Abstract
INTRODUCTION: Given the disproportionate burden of food insecurity in the southern US states and the high prevalence of caregiving in this area, we assessed caregiving-related predictors of food insecurity among caregivers in 4 southern US states. METHODS: We used data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) for individuals aged 18 years or older who resided in Alabama, Louisiana, Mississippi, and Tennessee to assess the association between caregiving status and food insecurity, accounting for the complex survey design of BRFSS. Caregiving-related predictors of food insecurity were identified by using multivariable logistic regression. RESULTS: Weighted counts of caregivers and noncaregivers were 356,198 and 652,737, respectively. Prevalence of food insecurity was higher among caregivers than noncaregivers (35.9% vs 25.9%). Adjusting for sociodemographic predictors, caregivers had 56% (95% CI, 1.30-1.87; P < .001) higher odds of food insecurity than noncaregivers. Among caregivers, those caring for a spouse or a partner (adjusted odds ratio [aOR] = 1.7; 95% CI, 1.02-2.85; P = .04) had significantly higher odds of food insecurity compared with those caring for parents or parents-in-law. Caregivers who had been caregiving for 6 months to 2 years had higher odds of food insecurity compared with those who had been caregiving for less than 6 months (aOR = 1.88; 95% CI, 1.12-3.16; P = .02). Caregivers who reported a need for support services had higher odds of food insecurity compared with those who did not (aOR = 3.38; 95% CI, 2.19-5.21; P < .001). Caregivers caring for people with musculoskeletal conditions, compared with people with neurologic conditions, had higher odds of food insecurity (aOR = 3.47; 95% CI, 1.52-7.91; P = .003). CONCLUSION: Caregiver screening for food insecurity in health care settings and linkage to appropriate food and caregiving support resources should be prioritized by future health policies.