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Home > JLPHA > Vol. 5 (2025) > No. 2 (2025)

 

Journal of the Louisiana Public Health Association

Journal of the Louisiana Public Health Association

Abstract

Background: Food insecurity (FI)–the lack of access to affordable, nutritious food–affects millions of Americans. Caddo Parish, Louisiana, is of interest due to high FI prevalence and socioeconomic risk factors. While FI is known to exacerbate chronic health issues, its association with neurological health remains understudied, especially in high-risk communities. Methods: A cross-sectional study was conducted among adult patients in Caddo Parish in 2022 using Epic Electronic Medical Record data to identify diagnoses of migraine, dementia, and stroke—the top neurological causes of disability-adjusted life years (DALYs) in the United States. FI status was determined using the Hunger Vital Sign screening questionnaire. Statistical analysis was performed in Statistical Product and Service Solutions (SPSS) using chi-square (X2) tests and Prevalence Odds Ratios (POR) to assess associations between FI and diagnoses. Results: FI was significantly associated with migraine overall (POR =1 .42, P < 0.001). When stratified by legal sex, gender, ethnicity, race, and age, additional significance was noted in FI females (POR = 1.36, P < 0.001), those of non-Hispanic ethnicity (POR=1.44, P < 0.001), Black (POR=1.32, P=0.005) and Caucasian (POR=1.62, P < 0.001) races, and those between the ages of 30 and 69 (30-49: POR=2.53, P < 0.001 , 50-69: POR=1.69, P < 0.001). There was no significant association between FI and stroke overall (P=0.262); however, significance was noted in FI patients of Black race (POR=0.819, P=0.048) and in patients above the age of 30 (30-49: POR=1.74, P < 0.001, 50 - 69: POR=1.46, P < 0.001, 70+: POR=0.116, P < 0.001). Though, in Black patients and persons above the age of 70 with FI, the association with stroke was negative. Overall, a negative association was observed in FI patients with dementia (POR = 0.565, P < 0.001). In addition, significance regarding dementia in FI patients were observed in females (POR=0.570, P=0.011), males (POR = 0.562, P = 0.037), non-Hispanic ethnicities (POR=0.567, P < 0.001), and black persons (POR=0.332, P < 0.001). Discussion: Our findings highlight FI as a potential modifiable risk factor for migraine and stroke in specific populations, emphasizing the need for screening and patient-centered support. The inverse relationships with dementia and stroke in select patient groups warrant further research. Conclusion: Enhanced screening and targeted interventions addressing FI may reduce the prevalence of neurological conditions and promote health equity in high-risk populations.

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