Abstract B173: Evaluating the role of language, age, nativity, spoken English comprehension, education level and employment status on degree of food insecurity among urban low- income, food-insecure cancer patients participating in a food insecurity RCT
Authors: Valentin-Figueroa Maria E , Macias Gualpa Carmen G. , Kakade Anagha , Claros Maria , Rodriguez Ashley , Gany Francesca 
Published: September 2024

Food insecurity (FI), the household-level economic and social condition of limited access to food, hinders a person’s ability to obtain high-quality health care. Chronic diseases worsen the detrimental effects of FI for several reasons, including treatment-cost financial burden and side effects that impede adequate food consumption. In some U.S. studies, an estimated 17% to 55% of patients reported FI following a cancer diagnosis. FI is highest among females, Hispanics, younger populations, unemployed individuals, and those with lower household incomes. However, there is insufficient literature exploring the link between various sociodemographic factors and the degree of FI in patients with cancer. This study evaluated the association between language, age, nativity, spoken English comprehension, education, employment, and degree of FI in breast and gynecological cancer patients enrolled, at the beginning of their cancer treatment, in a FI intervention RCT. Methods: A cross-sectional survey was conducted with patients recruited from 5 safety net cancer clinics in Bronx, NY, from 2019 to 2024. All participants were food insecure, measured using the U.S. Household Food Security 18-item Survey Module; participants were characterized as having either low food security (LFS, scores 3-7) or very low food security (VLFS, scores 8-18). We collected patient's preferred language, age, nativity, spoken English comprehension, highest education level achieved, and employment status at the start of their cancer treatment. Pearson’s Chi-squared tests (for categorical variables) and t-tests (for continuous variables) were used to evaluate FI association. Results: Of the 378 participants evaluated, 72.5% (N=274) reported LFS and 27.5% (N=104) VLFS. The median age was 57 years; 59.3% (N=211) of participants were foreign-born and 40.7% (N=145) US-born; 62.7% (N=237) preferred English and 37.3% (N=141) preferred Spanish; 59.7% (N=222) understood spoken English “Very well”, and 40.3% (N=150) “Well, Not well, or Not at all”. For education, 27.4% (N=101) completed primary school or less, 32.8% (N=121), secondary or high school or GED, 19.2% (N=71), some college or Associate degree, and 20.1% (N=74), Bachelor’s degree or higher. Preferred language was significantly associated with the degree of FI (p = 0.028), with LFS more likely among English-speaking participants. Additionally, there was an association between younger age and an increased likelihood of experiencing VLFS (p=0.004). There were no significant associations between nativity (p=0.738), spoken English comprehension (p=0.146), education (p=0.457), employment (p=0.530), and degree of FI. Conclusions: These findings highlight the complex and multifaceted nature of food security status among breast and gynecological cancer patients with FI, emphasizing the need for further research to understand and address the specific challenges faced by different demographic groups of patients with cancer, when providing food security support in their cancer care.

Citation Format: Maria E Valentin-Figueroa, Carmen G. Macias Gualpa, Anagha Kakade, Maria Claros, Ashley Rodriguez, Francesca Gany. Evaluating the role of language, age, nativity, spoken English comprehension, education level and employment status on degree of food insecurity among urban low- income, food-insecure cancer patients participating in a food insecurity RCT [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B173.