title: Urban-rural and regional variability in the prevalence of food insecurity: the survey of the health of Wisconsin.
abstract: BACKGROUND
  Food insecurity is a public health concern estimated to affect 18 million American households nationally, which can result in chronic nutritional deficiencies and other health risks. The relationships between food insecurity and specific demographic and geographic factors in Wisconsin are not well documented. The goals of this paper are to investigate sociodemographic and geographic features associated with food insecurity in a representative sample of Wisconsin adults.
  
  
  METHODS
  This study used data from the Survey of the Health of Wisconsin (SHOW). SHOW annually collects health-related data on a representative sample of Wisconsin residents. Between 2008-2012, 2,947 participants were enrolled in the SHOW study. The presence of food insecurity was defined based on the participant's affirmative answer to the question "In the last 12 months, have you been concerned about having enough food for you or your family?"
  
  
  RESULTS
  After adjustment for age, race, and gender, 13.2% (95% CI, 10.8%-15.1%) of participants reported food insecurity, 56.7% (95% CI, 50.6%-62.7%) of whom were female. Food insecurity did not statistically differ by region (P = 0.30). The adjusted prevalence of food insecurity in the urban core, other urban, and rural areas was 14.1%, 6.5%, and 10.5%, respectively. These differences were not statistically significant (P = 0.13) and, for urban core and rural areas, persisted even when accounting for level of economic hardship in the community.
  
  
  CONCLUSIONS
  The prevalence of food insecurity is substantial, affecting an estimated 740,000 or more Wisconsin residents. The prevalence was similarly high in all urbanicity levels and across all state public health regions in Wisconsin. Food insecurity is a common problem with potentially serious health consequences affecting populations across the entire state.
authors.forename: Natalie
authors.initials: N
authors.lastname: Guerrero
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Walsh
authors.forename: Kristen C
authors.initials: KC
authors.lastname: Malecki
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Nieto
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population; D014922:Wisconsin / Q000453:epidemiology