Association of food insecurity with gastrointestinal and hepatic conditions in U.S. adults: A population-based study

Abstract

Background Food insecurity affects 2.33 billion people worldwide and disproportionately impacts those with inflammatory bowel disease (IBD). However, population-level evidence linking food insecurity and gastrointestinal (GI) conditions remains limited. Aim To examine the association between food insecurity and GI conditions, including IBD, hepatitis, and GI cancers, among U.S. adults using national survey data. Methods We analyzed 2023–2024 National Health Interview Survey data from U.S. adults reporting food insecurity and GI conditions, including IBD, hepatitis, and GI cancers. Multivariable logistic regression assessed associations, adjusting for demographic and socioeconomic factors. Summary Among 57,860 adults, 14.1% of those with GI conditions reported food insecurity versus 8.8% without. Food insecurity was significantly associated with GI conditions (adjusted odds ratio (OR): 1.68; 95% CI: 1.44–1.97), particularly IBD (OR: 1.78; 95% CI: 1.42–2.23) and hepatitis (OR: 1.67; 95% CI: 1.33–2.09). Over half of food-insecure individuals with GI conditions (55.4%) lacked Supplemental Nutrition Assistance Program benefits; only 14.0% were up-to-date on colorectal cancer screening. Food insecurity is strongly linked to GI conditions, yet many lack assistance, indicating the importance of screening and interventions in GI care.