Housing and Food Insecurity and Chronic Disease Among Three Racial Groups in Hawaiʻi

INTRODUCTION: Food and housing insecurity are social determinants of health related to chronic disease, including diabetes, cardiovascular disease (CVD), and asthma. How these insecurities affect chronic disease among the 3 largest racial groups in Hawaiʻi is unknown. The purpose of this study was to examine chronic disease by housing and food insecurity among whites, Asians, and Native Hawaiian/other Pacific Islanders (NHOPIs) in Hawaiʻi. METHODS: We pooled data on 9,907 respondents from the 2009 and 2012 Behavioral Risk Factor Surveillance System. Dependent variables were diabetes, CVD, and asthma. Independent variables were housing and food insecurity. Logistic regression models were stratified by race to examine within-group differences by severity of insecurity. RESULTS: Compared with housing secure respondents, housing insecure NHOPIs had higher adjusted odds of diabetes (odds ratio [OR] = 1.85; 95% confidence interval [CI], 1.13–3.01) and CVD (OR = 1.85; 95% CI, 1.04–3.28), and housing insecure whites (OR = 1.52; 95% CI, 1.12–2.04) and Asians (OR = 1.93; 95% CI, 1.29–2.88) had higher adjusted odds of asthma. Compared with food secure participants, food insecure NHOPIs had higher adjusted odds of diabetes (OR = 2.17; 95% CI, 1.28–3.68); food insecure whites (OR = 1.88; 95% CI, 1.16–3.05) and NHOPIs (OR = 2.04; 95% CI, 1.10–3.78) had higher adjusted odds of CVD, and food insecure whites (OR = 1.53; 95% CI, 1.06–2.22) and Asians (OR = 1.79; 95% CI, 1.05–3.06) had higher adjusted odds of asthma. CONCLUSION: Housing and food insecurity are associated with higher rates of chronic diseases among some races in Hawaiʻi. Policy makers should work to increase affordable housing and improve policies to increase food affordability.