Evidence map›Paper›PMID 39639735›Full record

ArticleHealth services research2025

The relationship between food and housing insecurity and healthcare use among Virginia Medicaid expansion members: Considering the neighborhood context.

Hannah Shadowen, Sarah J Marks, Olufemi Obembe, Andrew Mitchell, Chethan Bachireddy, Anika Hines, Roy Sabo, Peter Cunningham, Alex Krist, Andrew Barnes

Abstract read
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In one paragraph

Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hannah ShadowenDepartment of Health Policy, School of Public Health, Virginia Commonwealth University, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0003-1939-7311
Sarah J MarksDepartment of Health Policy, School of Public Health, Virginia Commonwealth University, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0002-3468-3474
Olufemi ObembeVirginia Department of Medical Assistance Services, Richmond, Virginia, USA.
Andrew MitchellVirginia Department of Medical Assistance Services, Richmond, Virginia, USA.
Chethan BachireddyHarris Health System, Houston, Texas, USA.
Anika HinesDepartment of Health Policy, School of Public Health, Virginia Commonwealth University, Richmond, Virginia, USA.
Roy SaboDepartment of Biostatistics, School of Public Health, Virginia Commonwealth University, Richmond, Virginia, USA.
Peter CunninghamDepartment of Health Policy, School of Public Health, Virginia Commonwealth University, Richmond, Virginia, USA.
Alex KristDepartment of Family Medicine, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Andrew BarnesDepartment of Health Policy, School of Public Health, Virginia Commonwealth University, Richmond, Virginia, USA.

Funding

The relationship between social needs and primary care use after enrollment in Virginia’s Medicaid expansion: The influence of sociocultural and built environmentsF30MD018324 · NIMHD · VIRGINIA COMMONWEALTH UNIVERSITY · PI Hannah Shadowen · 2022 to 2026
$144k
Institute foInstitute for Minority Health and Health Disparities F30MD018324NIMHD NIH HHS 5F30MD018324-02NIMHD NIH HHS F30 MD018324Virginia Department of Medical Assistance Services 407
6 · The paper itself

Abstract

objectiveTo understand relationships between healthcare use and food and housing insecurity in Medicaid expansion members, as well as whether these relationships differ by rurality or residential segregation. DATA SOURCES AND STUDY

settingDatabase of Virginia Medicaid expansion members from the Department of Medical Assistance Services. Sample included individuals who enrolled January-June 2019, were aged 19-64 years, remained continuously enrolled for 12 months, and completed a Medicaid Member Health Screening (MMHS) conducted within the first 3 months of enrollment (n = 14,735). STUDY

designRetrospective cohort study. Outcomes included any primary care visits (PC) and any emergency department (ED) visits in the first 12 months of enrollment. The MMHS sample was weighted to represent all Medicaid expansion members (n = 234,296). Separate multivariable linear probability models regressed having any PC or ED visits on food and housing insecurity controlling for individual and neighborhood characteristics. Models were then stratified by rurality and racial residential segregation. DATA COLLECTION: None. PRINCIPAL

findingsFood insecurity was negatively associated with having any PC visit (-2.9 percentage points (PP); p-value <0.01) and positively associated with having any ED visit (7.0 PP; p-value <0.001). No significant relationships between PC or ED visits and housing insecurity were found. Suburban and urban individuals with food insecurity were significantly less likely to have any PC visit (p < 0.05 each). Medicaid expansion members living in disproportionately low-income or mixed-income neighborhoods experiencing food insecurity were also less likely to have any PC visits (p < 0.05), and the same was not true for those living in disproportionately high-income neighborhoods.

conclusionsFood insecurity among Medicaid expansion members is associated with less primary care and more emergency department use, but these relationships differ by the neighborhoods in which members live. Medicaid agency efforts that coordinate medical and social service benefits and also consider local context may further increase access to necessary and appropriate care.

Indexed as

Food InsecurityFood SupplyHousingMedicaidNeighborhood CharacteristicsPatient Acceptance of Health CareResidence CharacteristicsAdultEmergency Service, HospitalFemaleHumansMaleMiddle AgedPrimary Health CareRetrospective StudiesUnited Statesaccessfood insecurityhousing insecurityMedicaid expansionprimary careruralsegregation

Identifiers

PMID39639735
PMCPMC12047701

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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.