Background: Multimorbidity among parents, guardians, and caregivers may increase the risk of household food insecurity, which would negatively impact both parents and children. However, limited research has been done to evaluate this relationship among this population. To fill this gap, we examined the association between multimorbidity and food insecurity among U.S. parents.

Methods: Cross-sectional data from 2019 to 2022 of the National Health Interview Survey were analyzed. Parents, guardians, and caregivers with complete data (N = 26,579) were included. Multimorbidity is defined as having 2 or more conditions. In this study, multimorbidity was categorized as 2 or 3 + conditions from a sum of 11 chronic conditions: hypertension, hyperlipidemia, diabetes, arthritis, stroke, cancer, asthma, depression, anxiety, chronic obstructive pulmonary disease, and heart disease. The presence of food insecurity was defined in four nominal categories (secure, marginal food security, low food security, very low food security). Survey-weighted multinomial regression was used to assess the association of multimorbidity with food insecurity categories, controlling for sociodemographic characteristics. The association between physical versus physical-mental comorbidities and food insecurity was also analyzed.

Results: The mean study sample age was 38.8 years, 51% were women and 53% were non-Hispanic White race/ethnicity. Nearly half (49%) had ≥ 1 chronic condition; 23% had 1, 14% had 2, and 13% had 3+. The most common pair of chronic conditions among parents was depression and anxiety, and most common triad was depression, anxiety, and hypertension. After controlling for potential confounders, we found that parents with 3 + conditions had a higher risk of marginal (OR 1.75, 95% CI 1.47-2.10), low (OR 2.20, 95% CI 1.75-2.75), and very low food security (OR 4.1, 95% CI 3.2-5.2) compared to parents with no conditions. Differences were seen in the odds of food insecurity among parents with mental and physical conditions, as opposed to physical comorbidities alone.

Conclusions: Our findings suggest a higher risk of food insecurity in parents with multimorbidity. Parents with multimorbidity (especially those with comorbid depression and anxiety disorders) may be a key population to identify and intervene on food insecurity to improve health and well-being among US families.