Prevalence and determinants of food insecurity among United States cancer survivors based on the Medical Expenditure Panel Survey 2021

Food insecurity is a significant public health issue that adversely impacts the health outcomes of cancer survivors in the United States. This study estimated the prevalence of food insecurity among cancer survivors and identified its determinants in the year following the year of COVID-19 outbreak. This cross-sectional study used data from the nationally representative Medical Expenditure Panel Survey (MEPS) 2021, which collected information on respondents' health conditions (including history of cancer), healthcare utilization, sociodemographic characteristics, and access to food etc. This study included 2,500 adult respondents from MEPS 2021 who reported a history of cancer. Main outcome measure was food insecurity, which was defined based on responses to MEPS survey items regarding concerns about running out of food and the inability to afford food. Covariates included age, sex, race/ethnicity, marital status, educational attainment, poverty status, insurance status, and the number of comorbid conditions. The prevalence of food insecurity among cancer survivors was 13.47% overall in 2021. Younger cancer survivors (aged 18 to <50), those of non-Hispanic Black or non-Hispanic Asian/other race/ethnicity, those who were not married, had a high school diploma, had income <400% of FPL, were <65 years with public only insurance or 65+ with Medicare and other public only insurance coverage demonstrated higher likelihood of experiencing food insecurity compared to their respective counterparts. Our findings can inform policy efforts to ensure access to nutritious food for the most vulnerable cancer survivors during times of economic volatility and recovery, as experienced in the year after the COVID outbreak.