Housing and Food Insecurity, Health Literacy, and Maladaptive Coping Behaviors.

BACKGROUND: Stressors related to social determinants of health (SDH), such as housing and food insecurity, are implicated in chronic disease risk. Maladaptive strategies for coping with these stressors may exacerbate risk. OBJECTIVE: Given the limited research on SDH-related stressors and maladaptive coping, this study examined the relationship between two SDH-related stressors (housing and food insecurity) and maladaptive coping behaviors (i.e., emotional eating and stress-related cigarette and alcohol use) in adults. Further, because health literacy (HL), another SDH, may be a protective factor, this study explored whether HL moderated these relationships. METHODS: Data were collected from adults (N = 500, Mean age = 49.01 years, standard deviation = 16.36; 40% White) in the United States. A series of hierarchical logistic regressions predicting maladaptive coping behaviors from demographics, SDH-related stressors (i.e., housing or food insecurity), and HL variables were estimated. KEY RESULTS: Housing insecurity was associated with increased odds of emotional eating (odds ratio [OR] = 1.48, p < .001), stress-related cigarette use (OR = 1.34, p = .001), and stress-related alcohol use (OR = 1.32, p = .001). Food insecurity was associated with increased odds of emotional eating (OR = 1.49, p = .012), stress-related cigarette (OR = 1.68, p = .002), and stress-related alcohol use (OR = 1.49, p = .013). Higher functional HL scores were associated with decreased odds of emotional eating after accounting for housing (OR = 0.79, p = .017) and food insecurity (OR = 0.76, p = .004). Communicative and critical HL moderated the relationship between food insecurity and emotional eating. CONCLUSIONS: Examining HL in relation to SDH-related stressors and maladaptive coping behaviors is complex. HL may be less protective for maladaptive coping behaviors that are likely addictive. Because HL domains may require cooperation between individuals and systems related to stressors, multi-systemic interventions are necessary to reduce maladaptive coping behaviors. [HLRP: Health Literacy Research and Practice. 2022;6(4):e280-e289.] Plain language summary: Stress related to inadequate resources for housing and food may be related to adults' poor coping behaviors (e.g., emotional eating and stress-related cigarette and alcohol use). Adults who experienced housing and food insecurity were more likely to report emotional eating and using cigarettes and alcohol when stressed. Adults with higher functional health literacy were less likely to report emotional eating.

Health literacy and health behaviors in parent-adolescent dyads: an actor-partner interdependence model approach.

OBJECTIVE: Health literacy (HL), skills for accessing, appraising and using health information in health decision-making is implicated in adolescents' health behaviors. HL skills develop through scaffolding, modeling, practice and opportunity. Therefore, adolescents' HL skills are likely closely tied to parents' HL and health behaviors. Yet, no studies have examined the dyadic interdependence of the relationship between HL and health behaviors between parents and adolescents. The purpose of this study was to determine the interdependence of adolescents' and parents' HL and health behaviors. METHODS AND MEASURES: Data were collected from 300 parent-adolescent dyads via Qualtrics Panel. Dyads completed identical measures of their HL, diet, physical activity, sedentary activity, cigarette-smoking, vaping, and alcohol binge-drinking behaviors. Data were analyzed using Pearson correlations and the Actor-Partner Interdependence Model. RESULTS: Within-dyad correlations were significant for HL and all health behaviors assessed. After controlling for covariates and partner effects, adolescents' HL was related to their sugar-sweetened beverage intake, sedentary activity, and substance use. After controlling for covariates and actor effects, adolescents' HL was related to parents' sedentary activity, binge-drinking, and vaping while parents' HL was related to adolescents' sedentary activity. CONCLUSION: Our results suggest that there is interdependence in these relationships especially for risk behaviors.

Disparities in Adolescents' Obesogenic Behaviors, 2005-2017.

Objectives: Given the increasing national-level efforts to reduce disparities in obesogenic behaviors in youth, in this paper, we assessed the change in disparities in meeting guidelines for fruits and vegetables intake (FV), physical activity (PA), and sedentary behavior (SB) among adolescents in the United States in the last 13 years. Methods: Using the Youth Risk Behavior Surveillance System (2005-2017), overall and characteristic-specific (sex, age, race/ethnicity) disparities ratios for meeting FV, PA, and SB guidelines were calculated using the Extended Gastwirth Index Method. Linear regressions, one-way analysis of variance, and posthoc tests assessed change in characteristic-specific disparities over the years. Linear and quadratic trends assessed change in characteristic-specific contributions to overall disparities. Results: Sex-specific and age-specific disparities increased for meeting FV and PA and decreased for meeting SB guidelines. Race/ethnicity-specific disparities decreased for meeting FV and SB guidelines. Characteristics-specific contributions to overall disparities for each behavior changed over the years. Conclusions: Disparities in obesogenic behaviors are still an ongoing concern despite national-level efforts to improve adolescents' behaviors. The methodology allowed for meaningful disparities ratios that facilitated comparison of categorical demographic characteristics across the years and identifying targetable intervention groups to reduce disparities.

The Relationship Between Health Literacy, Cancer Prevention Beliefs, and Cancer Prevention Behaviors.

While cancer prevention behaviors have been clearly defined, many people do not engage in these risk-reduction behaviors. Factors such as cancer prevention beliefs and limited health literacy may undermine cancer prevention behavior recommendations. This study explored the relationships between cancer prevention beliefs, health literacy, and cancer prevention behaviors. Data were analyzed from the 2013 Health Information National Trends Survey (n = 1675). Regression analyses for four cancer prevention belief (prevention is not possible, cancer is fatal, there are too many recommendations for prevention, everything causes cancer) statements were modeled, including health literacy and sociodemographic variables as predictors. In addition, separate regression analyses predicted four cancer prevention behaviors (fruit and vegetable consumption, physical activity, cigarette smoking) from cancer prevention beliefs, health literacy, and sociodemographic variables. Participants with low health literacy were more likely to hold fatalistic cancer prevention beliefs than those with higher health literacy. Cancer prevention beliefs were related to less fruit and vegetable consumption, fewer days of physical activity, and with being a nonsmoker after controlling for sociodemographic variables. Health literacy was not a significant predictor of cancer prevention behaviors. Given the relationship between health literacy and cancer prevention beliefs, research is needed to ascertain how to empower patients with low health literacy to have a more realistic understanding of cancer.