{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T03:36:58Z","timestamp":1772595418201,"version":"3.50.1"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","issue":"17","license":[{"start":{"date-parts":[[2019,8,6]],"date-time":"2019-08-06T00:00:00Z","timestamp":1565049600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980019001885_as1\"><jats:title>Objective:<\/jats:title><jats:p>Food insecurity (FI) is defined as uncertain access to healthy food in quantity and quality. We hypothesize that FI may be associated with greater health-care use and absenteeism because it may amplify the effect of diseases; also, FI may be associated with reduced health-care access because it reflects economic vulnerability. The present study estimates the association between FI and health-care use and access, and absenteeism.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019001885_as2\"><jats:title>Design:<\/jats:title><jats:p>Cross-sectional data collected in 2015\u20132016. Health-care use was measured as the number of consultations, taking any drug and having been hospitalized in the past year. Health-care access was measured by the suspension of medication and having fewer consultations due to financial constraints. Absenteeism was measured by the weeks of sickness leave. Binary variables were modelled as a function of FI using logistic regressions; continuous variables were modelled as a function of FI using negative binomial and zero-inflated negative binomial regressions. Covariates were included sequentially.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019001885_as3\"><jats:title>Setting:<\/jats:title><jats:p>Portugal.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019001885_as4\"><jats:title>Participants:<\/jats:title><jats:p>Non-institutionalized adults from the EpiDoc3 cohort (<jats:italic>n<\/jats:italic>\u00a05648).<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019001885_as5\"><jats:title>Results:<\/jats:title><jats:p>FI was significantly associated with health-care use before controlling for socio-economic conditions and quality of life. Moderate\/severe FI was positively related to the suspension of medicines (adjusted OR = 4\u00b768; 95 % CI 3\u00b711, 6\u00b782) and to having fewer consultations (adjusted OR = 3\u00b798; 95 % CI 2\u00b742, 6\u00b737). FI and absenteeism were not significantly associated.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980019001885_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Our results support the hypothesis that FI reflects precariousness, which hinders access to health care. The greater use of health care among food-insecure people is explained by their worse quality of life and lower socio-economic condition, so that the specific role of poor nutrition is unclear.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980019001885","type":"journal-article","created":{"date-parts":[[2019,8,6]],"date-time":"2019-08-06T06:11:39Z","timestamp":1565071899000},"page":"3211-3219","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":19,"title":["Is food insecurity related to health-care use, access and absenteeism?"],"prefix":"10.1017","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3186-0807","authenticated-orcid":false,"given":"Ant\u00f3nio","family":"Melo","sequence":"first","affiliation":[]},{"given":"Maria Ana","family":"Matias","sequence":"additional","affiliation":[]},{"given":"Sara S","family":"Dias","sequence":"additional","affiliation":[]},{"given":"Maria 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