UC Irvine

Background: Latinos are disproportionally affected by both food insecurity and type II diabetes (T2D). Additionally, the relationship between food insecurity and T2D is more robust among Latinos compared to other racial/ethnic groups, underscoring the importance of examining this relationship in depth among this population. In this dissertation, I begin with a review of the literature and present a conceptual framework. I then examine three major aspects of the relationship between food insecurity and T2D among Latino adults by first identifying who is most at-risk for T2D when food insecure, second understanding the relationship between food insecurity and diet, and lastly, testing whether a community-level resource buffers this relationship. Methods: In Chapter Two, I determine which food-insecure Latinos are most at risk of having T2D. I use logistic regression to examine the association between food security status and T2D, and test whether nativity status and duration of residence moderate this association. In Chapter Three, I use exploratory factor analysis to derive dietary profiles among Latino adults and examine the association between food security status and these dietary profiles using OLS regression. In Chapter Four, I use logistic regression to test whether neighborhood social cohesion moderates the relationship between food security status and T2D. Results: I find that food security status is associated with T2D such that Latinos with higher levels of food insecurity are more likely to report having T2D, but this relationship differs among Latinos of different nativity and duration of residence in the United States. Latinos born in the United States and longer stay immigrant Latinos (10 years or more in the US) have a higher likelihood of having T2D when food insecure compared to recent immigrant Latinos (less than 10 years in the US). I also find that food security status is associated with some specific dietary profiles among Latinos adults. Compared to food-secure Latinos, those who are food insecure are more likely to have consumed diets high in vegetables and plant-based foods, but not more likely to have consumed diets high in high in hyperpalatable foods such as solid fats, cheese, and refined carbohydrates. Lastly, I find that neighborhood social cohesion does not modify or buffer the association between food security status and T2D. Conclusion: The findings from this dissertation have important implications for the overall health of Latinos and inform future research as well as interventions. One, this dissertation contributes to the literature by identifying the most at-risk Latinos (by nativity status and duration of residence) of the relationship between food security status and T2D. Two, this dissertation identifies nuances in dietary intake by different levels of food security among Latinos by highlighting that food insecurity is not associated with the consumption of poor dietary patterns, but is associated with decreased consumption of high-quality dietary patterns. Lastly, other psychosocial factors besides neighborhood social cohesion should be empirically tested to see how these factors might reduce food insecurity’s adverse impact among Latinos. Future research should examine more upstream factors such as policy to improve food environments and access to fresh and nutritious foods.