Introduction: The “Food is Medicine” movement calls upon medical and public health fields to recognize the role of food in chronic diseases, including heart disease. However, food insecurity may be a major barrier to health solutions that target dietary risk factors. The purpose of this study was to characterize trends in food insecurity among older adults, specifically considering those with coronary heart disease (CHD). Hypothesis: We assessed the hypothesis that adults aged ≥65 years with CHD would have higher levels of food insecurity compared to the general population. Methods: Annual survey data on older adults (≥65 years) from the National Health Interview Survey (2014-2024) were used; the annual analytic sample size ranged from 8,567 to 14,860. CHD was measured by self-report of a physician diagnosis. Food insecurity was assessed using the 11-item adult-focused questions of the validated questionnaire by the United States Department of Agriculture’s (USDA) Food Security Survey Model (FSSM) and was defined as ‘low’ and ‘very low’ food security. Survey weights were used to account for the complex survey sampling design. Differences in the prevalence of food insecurity were assessed across sociodemographic characteristics using chi-square tests. Results: Among all older adults, food insecurity in the total sample ranged from 3.54% (SE 0.26) in 2021 to 6.47% (SE 0.39) in 2014. Among older adults with CHD, food insecurity ranged from 5.24% (0.72) in 2021 to 9.18% (1.16) in 2016. Since 2019, adults with CHD have experienced disproportionately higher levels of food insecurity than the general population; in 2024, 7.42% of those with CHD reported food insecurity. In 2024, among older adults with CHD, those who identified as female (11.48% vs 4.92% males; p<0.001), non-Hispanic Black or Hispanic (Black 16.53% and Hispanic 20.64% vs 5.40% non-Hispanic White; p<0.001), living in single adult households (10.61% vs 6.28% ≥2 adult-household; p=0.02), and having a disability (11.26% vs 5.47% with no disability; p=0.002) were more likely to report food insecurity. Conclusion: Older adults with CHD experience higher levels of food insecurity than the general population. Continued monitoring of trends in food insecurity is needed. Health solutions focusing on dietary risk factors for chronic diseases should consider individual and structural barriers to healthy dietary patterns, including food insecurity, especially for those with CHD.
Owusu-Sekyere et al. (2026) studied this question.