Author ORCID Identifier
https://orcid.org/0000-0003-3436-5393
Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Healthcare Policy & Research
First Advisor
Anika Hines
Second Advisor
Jessica LaRose
Third Advisor
Maria Thomson
Fourth Advisor
Robert Perera
Abstract
BACKGROUND
Housing instability and food access are both robust risk factors for cardiovascular disease (CVD), which claims more lives annually in the U.S. than cancer and chronic lung disease combined. We hypothesized that experiencing both housing instability and food insecurity would have an additive effect on CVD risk, resulting in elevated blood pressure (BP) and perceived stress among young adults (YA).
METHODS
This research examined the relationships between food insecurity, housing instability, stress, and cardiovascular disease risk through three aims. First, multivariate linear regression was used to assess associations among YA, focusing on eviction, food insecurity, and blood pressure. Second, semi-structured interviews were used to explore shelter residents’ lived experiences with food and shelter access and stress. Third, we reviewed existing research on policies and programs that support healthy food acquisition among people without stable housing.
RESULTS
Experiencing eviction was not associated with BP among YA in a statistically or clinically significant way (SBP β= -1.50 p=0.55; DBP β=1.39, p=0.64), and food security did not show moderation effects in this relationship. Homeless individuals described a variety of stressors, but chronic health conditions emerged as an important stressor for these individuals. A scoping review yielded 14 peer-reviewed articles between 2002-2022 that specifically examined policies of programs aimed at addressing food insecurity for this population, highlighting the need for more research in this area.
CONCLUSION
Impacts of food security status and eviction may not interact as hypothesized. Further, food access may not always be prioritized over other basic needs. Most of the existing research examining food policies for the homeless focus on women and children. Expanding research to include this YA would provide valuable insights and inform targeted interventions that address food insecurity and chronic disease prevention.
Rights
© Sarah V. Collins
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-13-2024