ArticleThe American journal of managed care2018
Food insecurity, healthcare utilization, and high cost: a longitudinal cohort study.
Article in The American journal of managed care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 164 papers, 6 of them syntheses that pooled it.
What it found
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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
164 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- The impact of food insecurity on chronic liver disease: A systematic review of the literature.Hepatology communications · 2025Pooled it
- Health outcomes following childhood or adolescent exposure to household food insecurity: a rapid systematic review.Public health nutrition · 2025Pooled it
- Systematic review of fruit and vegetable voucher interventions for pregnant women and families with young children.Public health nutrition · 2025Pooled it
- A Systematic Literature Review of Nutrition Interventions Implemented to Address Food Insecurity as a Social Determinant of Health.Nutrients · 2023Pooled it
- Interventions to Address Food Insecurity Among Adults in Canada and the US: A Systematic Review and Meta-analysis.JAMA health forum · 2021Pooled it
- A Food Insecurity Systematic Review: Experience from Malaysia.Nutrients · 2021Pooled it
- Novel intervention to improve food insecurity among individuals with opioid use disorder: A randomized clinical trial.Drug and alcohol dependence · 2025Trial
- Randomized pilot trial of an unconditional cash transfer intervention to address food insecurity in oncology.JNCI cancer spectrum · 2024Trial
- A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients.BMC public health · 2023Trial
- "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
- Social Needs Screening and Subsequent Acute Care Utilization in a Large Safety-Net Health System: A Retrospective Cohort Study.Journal of general internal medicine · 2026Article
- Ending SNAP Eligibility for Refugees and Humanitarian Entrants: Food Access and Health Implications.Journal of immigrant and minority health · 2026Article
- Beyond the Kitchen Table: A Cross-Sectional Study on Food Insecurity and Emergency Department Use in the Community.Nursing open · 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
- Clarifying the Association Between Food Insecurity and Chronic Disease: Why Methods Matter.Current nutrition reports · 2026Review
- Inpatient Food Insecurity and Pediatric Hematology Oncology Hospitalization Outcomes.Pediatric blood & cancer · 2026Article
- Medically tailored meals receipt and healthcare utilization and costs in Massachusetts' Medicaid demonstration.Nature medicine · 2026Article
- Food Insecurity Among Medicare Beneficiaries in 2017-2022: A Longitudinal Cohort Study.Journal of the American Geriatrics Society · 2026Article
- Medicare Advantage's Provision of Expanded Supplemental Benefits and Acute Care Utilization.Health services research · 2026Article
- Beyond the Check Box: Development of the Nutrition Health Related Social Need Assessment and Referral Tool (N-HART).Journal of general internal medicine · 2026Article
104 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
objectivesReducing utilization of high-cost healthcare services is a common population health goal. Food insecurity-limited access to nutritious food owing to cost-is associated with chronic disease, but its relationship with healthcare utilization is understudied. We tested whether food insecurity is associated with increased emergency department (ED) visits, hospitalizations, and related costs. STUDY
designRetrospective analysis of a nationally representative cohort.
methodsAdults (≥18 years) completed a food insecurity assessment (using 10 items derived from the US Department of Agriculture Household Food Security Module) in the 2011 National Health Interview Survey and were followed in the 2012-2013 Medical Expenditures Panel Survey. Outcome measures were ED visits, hospitalizations, days hospitalized, and whether participants were in the top 10%, 5%, or 2% of total healthcare expenditures.
resultsOf 11,781 participants, 2056 (weighted percentage, 13.2%) were in food-insecure households. Food insecurity was associated with significantly more ED visits (incidence rate ratio [IRR], 1.47; 95% CI, 1.12-1.93), hospitalizations (IRR, 1.47; 95% CI, 1.14-1.88), and days hospitalized (IRR, 1.54; 95% CI, 1.06-2.24) after adjustment for demographics, education, income, health insurance, region, and rural residence. Food insecurity was also associated with increased odds of being in the top 10% (odds ratio [OR], 1.73; 95% CI, 1.31-2.27), 5% (OR, 2.53; 95% CI, 1.51-3.37), or 2% (OR, 1.95; 95% CI, 1.09-3.49) of healthcare expenditures.
conclusionsFood insecurity is associated with higher healthcare use and costs, even accounting for other socioeconomic factors. Whether food insecurity interventions improve healthcare utilization and cost should be tested.
Indexed as
Identifiers
30222918PMC6426124What OpenQuestion holds
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.