Transition to Adulthood: Dynamics of Disability and Food Insecurity

Background: Disability is a risk factor for food insecurity. When transitioning from childhood to adulthood, low-income individuals with disabilities are more likely to experience food insecurity and are less likely than when they were younger to receive support from the Supplemental Security Income and Medicaid and may be faced with more restricted eligibility for the Supplemental Nutrition Assistance Program (SNAP). In addition, young adults with disabilities are less likely than those without disabilities to participate in the labor force. These factors together may add to the risk of food insecurity, and also have an impact on their health/healthcare use. When faced with competing needs for food and healthcare, individuals with disabilities may have to prioritize these different basic needs. This study examines changing food insecurity status of children with disabilities from childhood to young adulthood, comparing their experience with that of their counterparts without disabilities.

Methods: We pooled the data from the 2011-2015 National Health Interview Survey, a national representative study with a cross-sectional design, and created a sample of low-income (<200% poverty threshold) individuals ages 13-26 (N=213,650). The dependent variable is a dichotomous indicator of household monthly food insecurity status (0=food secure; 1=food insecure) generated from the USDA’s 30-day Food Security Supplement. The key independent variables are disability status and transition into adulthood. A dichotomous measure of disability (1=with, 0=without a disability) is indicated by presence of any functional limitation. Transition into adulthood is measured by age: Those ages 13-17 have a value of “0”, and others have a value of “1”. A logit model including disability, transition into adulthood, and the interaction term between these two independent variables is used to predict household food insecurity. Control variables include personal/family characteristics, and state and survey year fixed-effect indicators.

Results: Less than 9% of sample respondents reported a disability condition. Children with disabilities are more likely to experience food insecurity compared to their counterparts without disabilities, with an odds ratio of 2.01 (p<.001). Young adults with disabilities also have a higher probability of food insecurity than those without disabilities (odds ratio = 2.43). The interaction term between disability and transition to young adulthood is also significant (p<.001), indicating a statistical difference between these two odds ratios. This difference is mainly a result of the decreased food insecurity rate from childhood to young adulthood among those without disabilities. Similar results are obtained when we limit the sample to those aged 15-22.

Implications: When transitioning from childhood to young adulthood, individuals with disabilities are less likely than those without disabilities to improve their food security status. Future research should examine the underlying mechanism of this difference and its impact on nutrition and other health outcomes. Findings of this study have policy implications for developing/implementing effective nutrition assistance programs for young adults with disabilities.