Patient-Provider Communication Among U.S. Adults With Food Insecurity.

Abstract

Food-insecure adults may experience poor patient-provider communication, potentially compromising care delivery, but this remains unclear. This study examined whether food-insecure adults face poorer patient-provider communication than food-secure adults and how this interplay affects access to care, healthcare utilization, and financial burden of care. This study used data from the 2016, 2017, and 2021 Medical Expenditure Panel Survey. Outcomes included patient-provider communication, access to care, healthcare utilization, and financial burden of care. Key independent variables were patient-provider communication and food insecurity. Analysis was conducted in September 2024. Food-insecure adults reported poorer patient-provider communication than food-secure adults, with 9.0% (95% CI=7.7, 10.3) and 56.0% (95% CI=53.9, 58.2) reporting low and moderate communication among food-insecure adults vs 4.3% (95% CI=4.1, 4.6) and 50.7% (95% CI=50.0, 51.4) reporting low and moderate communication among food-secure adults. Furthermore, food insecurity was associated with lower access to care, higher emergency departments visits, and greater financial burdens, particularly among adults with low communication. Among adults with low communication, the likelihood of having a usual source of care was lower for food-insecure adults than for food-secure adults: 69.9% (95% CI=61.3, 78.6) vs 84.2% (95% CI=79.8, 88.6). Among adults with low communication, food-insecure adults had higher rates of emergency department visits (40.2%; 95% CI=34.5, 45.8 vs 20.1%; 95% CI=17.6, 22.6) and reported experiencing problems in paying medical bills (43.7%; 95% CI=37.6, 49.8 vs 20.1%; 95% CI=17.6, 22.6) compared with food-secure adults. These results underscore the complex healthcare needs of food-insecure populations and highlight the need to enhance communication strategies to effectively address.