ArticleHealth services research2018
Food Insecurity and Health Care Expenditures in the United States, 2011-2013.
Article in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 146 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
146 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Health outcomes following childhood or adolescent exposure to household food insecurity: a rapid systematic review.Public health nutrition · 2025Pooled it
- Expanding the limits of sex: a systematic review concerning food and nutrition in transgender populations.Public health nutrition · 2021Pooled it
- Pooled it
- Randomized pilot trial of an unconditional cash transfer intervention to address food insecurity in oncology.JNCI cancer spectrum · 2024Trial
- "I was able to eat what I am supposed to eat"-- patient reflections on a medically-tailored meal intervention: a qualitative analysis.BMC endocrine disorders · 2020Trial
- Food insecurity and mental health in South Africa: Structural pathways linking socioeconomic position, behavioural risk factors and comorbidity.Preventive medicine reports · 2026Article
- Relationships Among COVID-19 Contraction, Job Loss, and Food Insecurity in American Indian and Alaska Native Peoples.Journal of racial and ethnic health disparities · 2026Article
- Higher and Lower Intensity Outreach to Increase Enrollment in a Medicaid Food Is Medicine Program: A Randomized Controlled Trial.Journal of general internal medicine · 2026Article
- Universal free school meals and Medicaid spending: evidence from linked education and claims data in Arkansas.Health affairs scholar · 2026Article
- Participatory Design Process of a Supportive Digital Platform to Enhance Local Urban Food Systems.Foods (Basel, Switzerland) · 2026Article
- Beyond Breakfast: Exploring What Works for Schools Delivering School Breakfast Programs in Queensland, Australia.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2026Article
- Out-of-Pocket Costs and Health-Related Social Needs Among Households With Children.JAMA network open · 2026Article
- Changes in Food Security and Diet Quality After the 2021 SNAP Benefit Increase in Massachusetts, USA.Nutrients · 2026Article
- Uncovering the Roots of Inequity: Social Determinants and Racial Disparities Among Gastrointestinal Cancer Patients.Journal of racial and ethnic health disparities · 2026Article
- Implementation and costs of a food insecurity resource navigation program for primary care patients with diabetes and hypertension in South Carolina.Preventive medicine reports · 2026Article
- Assessing food insecurity severity and lived experiences among Sub-Saharan African migrants in Turkey: evidence from a rasch-based mixed-methods study.BMC public health · 2026Article
- Employment status and food insecurity in cancer survivorship: evidence from the medical expenditure panel survey.Cancer causes & control : CCC · 2026Article
- Fresh Food Rx: Evaluating the Impact of a Produce Prescription Program on Engagement and Well-being Using the RE-AIM Framework.Journal of general internal medicine · 2026Article
- Healthcare and Nonhealthcare Costs: Youth With Diabetes and Food Insecurity.American journal of preventive medicine · 2026Observational
- Direct and Indirect Pathways Between Food Insecurity and Glycemic Control in Adults with Diabetes.Journal of general internal medicine · 2026Article
86 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveTo determine whether food insecurity, limited or uncertain food access owing to cost, is associated with greater health care expenditures. DATA SOURCE/STUDY
settingNationally representative sample of the civilian noninstitutionalized population of the United States (2011 National Health Interview Survey [NHIS] linked to 2012-2013 Medication Expenditure Panel Survey [MEPS]). STUDY
designLongitudinal retrospective cohort. DATA COLLECTION/EXTRACTION
methodsA total of 16,663 individuals underwent assessment of food insecurity, using the 10-item adult 30-day food security module, in the 2011 NHIS. Their total health care expenditures in 2012 and 2013 were recorded in MEPS. Expenditure data were analyzed using zero-inflated negative binomial regression and adjusted for age, gender, race/ethnicity, education, income, insurance, and residence area. PRINCIPAL
findingsFourteen percent of individuals reported food insecurity, representing 41,616,255 Americans. Mean annualized total expenditures were $4,113 (standard error $115); 9.2 percent of all individuals had no health care expenditures. In multivariable analyses, those with food insecurity had significantly greater estimated mean annualized health care expenditures ($6,072 vs. $4,208, p < .0001), an extra $1,863 in health care expenditure per year, or $77.5 billion in additional health care expenditure annually.
conclusionsFood insecurity was associated with greater subsequent health care expenditures. Future studies should determine whether food insecurity interventions can improve health and reduce health care costs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.