TY - JOUR T1 - Chronic disease burden predicts food insecurity among older adults. JF - Public Health Nutrition Y1 - 2018 A1 - Jih, Jane A1 - Stijacic-Cenzer, Irena A1 - Hilary K Seligman A1 - W John Boscardin A1 - Thu T Nguyen A1 - Christine S Ritchie KW - Chronic conditions KW - Comorbidity KW - Food insecurity AB -

OBJECTIVE: Increased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity.

DESIGN: Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS.

SETTING: USA.

SUBJECTS: Respondents of the 2013 HRS HCNS with household incomes <300 % of the federal poverty line (n 3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0-1, 2-4, ≥5 conditions), with multiple chronic conditions (MCC) defined as ≥2 conditions.

RESULTS: The prevalence of food insecurity was 27·8 %. Compared with those having 0-1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2-4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37).

CONCLUSIONS: A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

VL - 21 IS - 9 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29388533?dopt=Abstract ER - TY - JOUR T1 - Leveraging the health and retirement study to advance palliative care research. JF - J Palliat Med Y1 - 2014 A1 - Amy Kelley A1 - Kenneth M. Langa A1 - John G. Cagle A1 - Katherine A Ornstein A1 - Maria J Silveira A1 - Lauren Hersch Nicholas A1 - Kenneth E Covinsky A1 - Christine S Ritchie KW - Aged KW - Caregivers KW - Evidence-Based Practice KW - Health Services Research KW - Health Surveys KW - Humans KW - Longitudinal Studies KW - Needs Assessment KW - Pain Management KW - Palliative care KW - Quality of Life KW - Retirement KW - Sociological Factors KW - United States AB -

BACKGROUND: The critical need to expand and develop the palliative care evidence base was recently highlighted by the Journal of Palliative Medicine's series of articles describing the Research Priorities in Geriatric Palliative Care. The Health and Retirement Study (HRS) is uniquely positioned to address many priority areas of palliative care research. This nationally representative, ongoing, longitudinal study collects detailed survey data every 2 years, including demographics, health and functional characteristics, information on family and caregivers, and personal finances, and also conducts a proxy interview after each subject's death. The HRS can also be linked with Medicare claims data and many other data sources, e.g., U.S. Census, Dartmouth Atlas of Health Care.

SETTING: While the HRS offers innumerable research opportunities, these data are complex and limitations do exist. Therefore, we assembled an interdisciplinary group of investigators using the HRS for palliative care research to identify the key palliative care research gaps that may be amenable to study within the HRS and the strengths and weaknesses of the HRS for each of these topic areas.

CONCLUSION: In this article we present the work of this group as a potential roadmap for investigators contemplating the use of HRS data for palliative care research.

PB - 17 VL - 17 IS - 5 U1 - http://www.ncbi.nlm.nih.gov/pubmed/24694096?dopt=Abstract U2 - PMC4012620 U4 - Caregivers/Evidence-Based Practice/Needs Assessment/Pain Management/Palliative Care ER -