Prevalence and Determinants of Food Insecurity among United States Cancer Survivors Based on the Medical Expenditure Panel Survey 2021.
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UNLABELLED: Food insecurity is a significant public health issue that adversely affects the health outcomes of cancer survivors in the United States. This study estimated the prevalence of food insecurity among cancer survivors and identified its determinants in the year following the year of the COVID-19 outbreak. This cross-sectional study used data from the nationally representative Medical Expenditure Panel Survey (MEPS) 2021, which collected information on respondents' health conditions (including history of cancer), healthcare utilization, sociodemographic characteristics, access to food, etc. This study included 2,500 adult respondents from MEPS 2021 who reported a history of cancer. The main outcome measure was food insecurity, which was defined based on responses to MEPS survey items regarding concerns about running out of food and the inability to afford food. Covariates included age, sex, race/ethnicity, marital status, educational attainment, poverty status, insurance status, and the number of comorbid conditions. The prevalence of food insecurity among cancer survivors was 13.47% overall in 2021. Younger cancer survivors (ages 18 to <50 years), those of non-Hispanic Black or non-Hispanic Asian/other race/ethnicity, those who were not married, had a high school diploma, had income <400% of federal poverty level, were <65 years with public only insurance or 65+ years with Medicare, and other public only insurance coverage demonstrated higher likelihood of experiencing food insecurity compared with their respective counterparts. Our findings can inform policy efforts to ensure access to nutritious food for the most vulnerable cancer survivors during times of economic volatility and recovery, as experienced in the year after the COVID outbreak. SIGNIFICANCE: In this study using the nationally representative MEPS 2021 data, we found that more than 13% of cancer survivors experienced food insecurity in the year following the year of the COVID-19 outbreak, whereas certain subgroups, including younger and lower-income individuals, were especially vulnerable.