Healthcare and Nonhealthcare Costs: Youth With Diabetes and Food Insecurity

This study prospectively evaluated the association of household food insecurity with acute care costs and productivity loss in youth and young adults with Type 1 and Type 2 diabetes.

This observational cohort study included 1,256 youth and young adults with Type 1 and Type 2 diabetes from the SEARCH for Diabetes in Youth Food Security Study, with data collected at 3 time points between 2015 and 2022. Both household food insecurity (measured using the U.S. Household Food Security Survey Module) and costs (measured using survey responses on utilization and productivity losses) were self-reported by young adult participants or the caregivers of adolescents. The relationship between household food insecurity and costs was analyzed using generalized adjusted linear regression. The authors also analyzed the moderating role of continuous health insurance coverage.

Each additional 1-point increase in the household food insecurity score was associated with a $1,077 (95% CI=663; 1,491) increase in measured 12-month costs. Costs were $4,384 (95% CI=2,635; 6,133) higher in households that were experiencing household food insecurity than in those that were not. Youth and young adults with continuous health insurance coverage saw smaller increases in costs ($864, 95% CI=461; 1,267) than those without continuous coverage ($1,820; 95% CI=379; 3,261).

This study found a positive association between household food insecurity and costs for youth and young adults with diabetes, and this relationship was modified by continuous health insurance coverage. Future work should use linked claims and electronic health record data to better inform efforts aimed at reducing household food insecurity burden and improving the continuity of insurance coverage for this population.