Food Insecurity and Cost-Related Medication Underuse Among Nonelderly Adults in a Nationally Representative Sample.
OBJECTIVE
We investigated whether nonelderly US adults (aged 18-64 years) in food-insecure households are more likely to report cost-related medication underuse than the food-secure, and whether the relationship between food insecurity and cost-related medication underuse differs by gender, chronic disease, and health insurance status.


METHODS
We analyzed data from the 2011 and 2012 National Health Interview Survey (n = 67 539). We examined the relationship between food insecurity and cost-related medication underuse with the χ(2) test and multivariate logistic regression with interaction terms.


RESULTS
Bivariate and multivariate analyses showed a dose-response relationship between food insecurity and cost-related medication underuse, with an increasing likelihood of cost-related medication underuse with increasing severity of food insecurity (P < .001). This association was conditional on health insurance status, but not substantially different by gender or chronic disease status. Being female, low-income, having no or partial health insurance, chronic conditions, functional limitations, or severe mental illness were positively associated with cost-related medication underuse.


CONCLUSIONS
Using food insecurity as a risk factor to assess cost-related medication underuse could help increase identification of individuals who may need assistance purchasing medications and improve health for those in food-insecure households.
Dena Herman is with the Department of Family and Consumer Sciences, California State University Northridge, Northridge, CA. Patience Afulani and Gail G. Harrison are with the Fielding School of Public Health, University of California, Los Angeles. Alisha Coleman-Jensen is with Economic Research Service, US Department of Agriculture, Washington, DC.
Dena
D
Herman
Dena Herman is with the Department of Family and Consumer Sciences, California State University Northridge, Northridge, CA. Patience Afulani and Gail G. Harrison are with the Fielding School of Public Health, University of California, Los Angeles. Alisha Coleman-Jensen is with Economic Research Service, US Department of Agriculture, Washington, DC.
Patience
P
Afulani
Dena Herman is with the Department of Family and Consumer Sciences, California State University Northridge, Northridge, CA. Patience Afulani and Gail G. Harrison are with the Fielding School of Public Health, University of California, Los Angeles. Alisha Coleman-Jensen is with Economic Research Service, US Department of Agriculture, Washington, DC.
Alisha
A
Coleman-Jensen
Dena Herman is with the Department of Family and Consumer Sciences, California State University Northridge, Northridge, CA. Patience Afulani and Gail G. Harrison are with the Fielding School of Public Health, University of California, Los Angeles. Alisha Coleman-Jensen is with Economic Research Service, US Department of Agriculture, Washington, DC.
Gail G
GG
Harrison
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D005523:Food Supply; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors