HANDLS Study Looks at Impact of Food Insecurity on Health


We know the health benefits of making smart food choices—learn more in NIA’s booklet What’s On Your Plate?—but what if you couldn’t afford these nutritious foods? This problem, called “food insecurity,” is a serious issue facing many underserved communities.

“Food insecurity is not just a socioeconomic issue, it’s a public health issue. We talk about the importance of nutritious foods for healthy aging, but for some people, this is just not an option,” said Michele Evans, M.D., Deputy Scientific Director of NIA’s Intramural Research Program and Co-Principal Investigator of NIA’s Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS).

Dr. Evans, along with study Co-Principal Investigator Alan Zonderman, Ph.D., and scientists at University of Maryland Baltimore County, recently investigated the health effect of food insecurity among 2,802 urban-dwelling HANDLS participants. They found that having limited access to adequate food and nutrition due to financial constraints was associated with higher rates of hypertension.

The Baltimore-based HANDLS study—featured in the fall 2009 issue of LINKS—looks at the differences in rates and risks for diseases and other conditions associated with aging among black and white participants of low (below 125% of poverty level) and higher socioeconomic status. The study also looks for differences in longevity. One thing that makes this community-based study unique is that investigators visit participants using a mobile medical research vehicle and participants are followed over time, or longitudinally.

Researchers found that approximately one in four of the HANDLS participants surveyed had experienced some food insecurity over the last year. Responses were grouped by severity, mild having experienced food insecurity once or twice, moderate some but not every month, and severe almost every month. The investigators then looked at the association between food insecurity and hypertension—a major risk factor for cardiovascular disease—among white and among black participants, adjusting for factors including poverty status, age, sex, substance use, body mass index, disease history, and symptoms of depression.

Black participants who experienced moderate or severe food insecurity and white participants who experienced severe food insecurity had higher rates of hypertension, compared to those black and white participants (respectively) who had adequate access to food. There was no association between moderate food insecurity and hypertension among white HANDLS participants, suggesting that the link between the two factors was stronger for black participants than for white participants.

“These findings may help explain one of the ways having limited financial resources influences health,” said Dr. Zonderman. “And, it could potentially have policy implications in the future.”

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