{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:12:45Z","timestamp":1788894765638,"version":"build-2803163510"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Food insecurity is associated with high morbidity and mortality and is typically measured with the 10-item US Adult Food Security Survey Module. Shorter instruments may capture similar information, but this has not been validated against mortality in general populations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              A nationally representative sample of individuals aged 20 to 74 years from the US National Health Interview Survey 2011 to 2018 was included, with deaths linked to the National Death Index through 2019. Cardiovascular disease deaths were ascertained by\n              <jats:italic>International Classification of Diseases-Tenth Revision<\/jats:italic>\n              codes for heart disease or stroke. Standard 10-, 6-, and 2-item food security instruments were compared for associations with premature all-cause and cardiovascular disease deaths occurring before age 75 years using Cox regression adjusted for demographics and social determinants of health and C statistics. Findings were replicated in the National Health and Nutrition Examination Survey 2004 to 2018, and differences were explored using mediation analysis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>We included 218\u2005136 National Health Interview Survey participants (mean age, 45.3 years; 50.8% women). Over a mean 5.0-year follow-up, 7025 premature deaths were observed (1711 from cardiovascular disease). In multivariable-adjusted models, hazard ratios (95% CIs) for all-cause death were similar among food security instruments (10-item, 1.22 [1.13, 1.32]; 6-item, 1.23 [1.13, 1.34]; and 2-item, 1.23 [1.14, 1.32]), and C statistics were identical (0.823). Hazard ratios (95% CIs) for cardiovascular disease deaths were also similar among food security instruments (10-item, 1.38 [1.17, 1.62]; 6-item, 1.27 [1.07, 1.51]; and 2-item, 1.41 [1.20, 1.66]), and C statistics ranged from 0.852 to 0.853. In the National Health and Nutrition Examination Survey replication (n=37\u2005027, mean 7.8-year follow-up), associations were attenuated and became not statistically significant after adjustment for several cardiometabolic intermediates, particularly enrollment in food assistance programs, diabetes, low diet quality, inadequate or excessive sleep, and depression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>A 2-item food security instrument captures similar mortality risk information compared with 10- and 6-item instruments. Furthermore, potential intermediate cardiometabolic factors may explain associations between food insecurity and mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.124.011209","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T10:00:39Z","timestamp":1736416839000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of Associations of Food Security Instruments and Mediators With Premature All-Cause and Cardiovascular Disease Death in US Adults"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8521-9575","authenticated-orcid":true,"given":"Ling","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Epidemiology (L.T., K.S.D., K.P.T., J.D.B.), Tulane University School of Public Health and Tropical Medicine, New Orleans, LA."},{"name":"Translational Science Institute, Tulane University, New Orleans, LA (L.T., K.S.D., J.D.B.)"},{"name":"Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (L.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-2299","authenticated-orcid":true,"given":"Byron C.","family":"Jaeger","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (B.C.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4266-1830","authenticated-orcid":true,"given":"Allison N.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Human Science, School of Health, Georgetown University, Washington, DC (A.N.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3182-5633","authenticated-orcid":true,"given":"Kirsten S.","family":"Dorans","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (L.T., K.S.D., K.P.T., J.D.B.), Tulane University School of Public Health and Tropical Medicine, New Orleans, LA."},{"name":"Translational Science Institute, Tulane University, New Orleans, LA (L.T., K.S.D., J.D.B.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8392-3721","authenticated-orcid":true,"given":"Caryn N.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Social Behavioral and Population Science (C.N.B., K.P.T.), Tulane University School of Public Health and Tropical Medicine, New Orleans, LA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6371-1959","authenticated-orcid":true,"given":"Katherine P.","family":"Theall","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (L.T., K.S.D., K.P.T., J.D.B.), Tulane University School of Public Health and Tropical Medicine, New Orleans, LA."},{"name":"Department of Social Behavioral and Population Science (C.N.B., K.P.T.), Tulane University School of Public Health and Tropical Medicine, New Orleans, LA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-9126","authenticated-orcid":true,"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, the Charles and Jane Pak Center for Mineral Metabolism and Clinical Research (J.C.), UT Southwestern Medical Center, Dallas, TX."},{"name":"Department of Internal Medicine (J.C., J.H.), UT Southwestern Medical Center, Dallas, TX."},{"name":"Department of Epidemiology, Peter O\u2019Donnell Jr School of Public Health (J.C., J.H.), UT Southwestern Medical Center, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8286-9652","authenticated-orcid":true,"given":"Jiang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (J.C., J.H.), UT Southwestern Medical Center, Dallas, TX."},{"name":"Department of Epidemiology, Peter O\u2019Donnell Jr School of Public Health (J.C., J.H.), UT Southwestern Medical Center, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6054-2624","authenticated-orcid":true,"given":"Joshua D.","family":"Bundy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (L.T., K.S.D., K.P.T., J.D.B.), Tulane University School of Public Health and Tropical Medicine, New Orleans, LA."},{"name":"Translational Science Institute, Tulane University, New Orleans, LA (L.T., K.S.D., J.D.B.)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71146-6"},{"key":"e_1_3_3_3_2","unstructured":"World Health Organization. A conceptual framework for action on the social determinants of health. 2010. https:\/\/iris.who.int\/handle\/10665\/44489"},{"key":"e_1_3_3_4_2","unstructured":"Gregory CA Coleman-Jensen A. Food insecurity chronic disease and health among working-age adults. http:\/\/www.ers.usda.gov\/publications\/pub-details\/?pubid=84466"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.11.016"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2019.01.014"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014629"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.3729"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000228"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001209"},{"key":"e_1_3_3_11_2","unstructured":"USDA. Household food security in the United States in 1995: summary report of the Food Security Measurement Project. Accessed October 25 2024. https:\/\/www.fns.usda.gov\/household-food-security-united-states-1995-summary-report-food-security-measurement-project"},{"key":"e_1_3_3_12_2","unstructured":"USDA. Food security in the U.S. Accessed October 25 2024. https:\/\/www.ers.usda.gov\/topics\/food-nutrition-assistance\/food-security-in-the-u-s\/"},{"key":"e_1_3_3_13_2","unstructured":"Food and Agriculture Organization of the United Nations. The state of food security and nutrition in the world 2023. WHO; 2023. http:\/\/www.fao.org\/documents\/card\/en\/c\/cc3017en"},{"key":"e_1_3_3_14_2","unstructured":"USDA. Survey tools. Accessed October 25 2024. https:\/\/www.ers.usda.gov\/topics\/food-nutrition-assistance\/food-security-in-the-u-s\/survey-tools\/"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.89.8.1231"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3146"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-019-02785-6"},{"key":"e_1_3_3_18_2","volume-title":"IPUMS Health Surveys: National Health Interview Survey, Version 7.4","author":"Blewett LA","year":"2024","unstructured":"Blewett LA, Rivera Drew JA, King ML, Williams KCW, Backman D, Chen A, Richards S. IPUMS Health Surveys: National Health Interview Survey, Version 7.4. IPUMS, 2024. https:\/\/doi.org\/10.18128\/D070.V7.4"},{"key":"e_1_3_3_19_2","unstructured":"Centers for Disease Control and Prevention. NHIS - National Health Interview Survey Homepage. Accessed October 25 2024. https:\/\/www.cdc.gov\/nchs\/nhis\/about_nhis.htm"},{"key":"e_1_3_3_20_2","unstructured":"Centers for Disease Control and Prevention. NHANES - National Health and Nutrition Examination Survey Homepage. Accessed October 25 2024. https:\/\/www.cdc.gov\/nchs\/nhanes\/index.htm"},{"key":"e_1_3_3_21_2","unstructured":"Office of Disease Prevention and Health Promotion. Social determinants of health - healthy people 2030. Accessed October 25 2024. https:\/\/health.gov\/healthypeople\/priority-areas\/social-determinants-health"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.18.1737"},{"key":"e_1_3_3_23_2","unstructured":"Center for Nutrition Policy and Promotion. Healthy Eating Index (HEI) | food and nutrition service. https:\/\/www.fns.usda.gov\/cnpp\/healthy-eating-index-hei"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.7326\/M23-0507"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004966"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:112079"},{"key":"e_1_3_3_27_2","unstructured":"National Center for Health Statistics. The linkage of survey data to the national death index-2019 Linked Mortality File (LMF): linkage methodology and analytic considerations. Accessed October 25 2024. https:\/\/www.cdc.gov\/nchs\/data-linkage\/mortality-methods.htm"},{"key":"e_1_3_3_28_2","unstructured":"Lumley T. Survey: analysis of complex survey samples. Accessed October 25 2024. https:\/\/cran.r-project.org\/web\/packages\/survey\/index.html"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2019.02.016"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216666564"},{"key":"e_1_3_3_31_2","volume-title":"Statistical Analysis With Missing Data","author":"Little RJA","unstructured":"Little RJA, Rubin DB. Statistical Analysis With Missing Data. Third Edition. Wiley. Accessed October 25, 2024. https:\/\/onlinelibrary.wiley.com\/doi\/book\/10.1002\/9781119013563"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10301016"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rec.2021.06.003"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021901"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.5334\/jors.160"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7977"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00081-6"},{"key":"e_1_3_3_40_2","unstructured":"USDA. Guide to Measuring Household Food Security (Revised 2000) | Food and Nutrition Service. Accessed October 25 2024. https:\/\/www.fns.usda.gov\/research\/guide-measuring-household-food-security-revised-2000"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-040119-094143"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001072"},{"key":"e_1_3_3_43_2","unstructured":"Food and Agriculture Organization of the United Nations. The food insecurity experience scale: measuring food insecurity through people\u2019s experiences. Accessed October 25 2024. https:\/\/openknowledge.fao.org\/items\/b24b439d-3587-4b39-96be-865a09e7058f"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.5539\/JAS.V6N2P132"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2891-8-28"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1017\/S136898000999214X"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.measurement.2017.10.065"},{"key":"e_1_3_3_48_2","unstructured":"Coleman-Jensen A Rabbitt MP Gregory CA Singh A. Statistical supplement to household food security in the United States in 2020. Accessed October 25 2024. http:\/\/www.ers.usda.gov\/publications\/pub-details\/?pubid=102071"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2023.03.012"}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.124.011209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T19:00:31Z","timestamp":1739905231000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.124.011209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":48,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.124.011209"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.124.011209","relation":{},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}