Location
Moultrie, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
INTRODUCTION
Food insecurity is a key structural determinant of health associated with adverse physical and psychological outcomes. Individuals with attention-deficit/hyperactivity disorder (ADHD) may be particularly vulnerable due to executive dysfunction, psychosocial stress, and socioeconomic instability. The association between ADHD status, medication use, and food insecurity, however, has not been well characterized in large national cohorts.
OBJECTIVE
To evaluate the association between ADHD status (with and without medication) and food insecurity in the All of Us Research Program cohort.
METHODS
We conducted a cross-sectional analysis of 142,725 eligible participants from the All of Us Research Program. ADHD status was categorized as ADHD with medication, ADHD without medication, and no ADHD (reference group). The primary outcome was self-reported food insecurity. Group differences in food insecurity by ADHD status were assessed using chi-square tests. Multivariable logistic regression models were then used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for food insecurity. Sequential models were constructed: (1) unadjusted; (2) adjusted for age, gender identity, and race/ethnicity; and (3) fully adjusted for age, gender identity, race/ethnicity, income category, and perceived stress. To assess potential effect modification, interaction terms between ADHD status and income were included. A sensitivity analysis restricted to participants with ADHD was performed to examine the association between medication status and food insecurity.
RESULTS
Food insecurity was reported in 21,546 participants. Chi-square analyses demonstrated significant differences in food insecurity prevalence across ADHD groups (p< 0.001). In unadjusted logistic regression models, both ADHD groups had increased odds of food insecurity compared to controls (ADHD without medication OR=2.35, 95% CI 2.04–2.71; ADHD with medication OR=2.00, 95% CI 1.85–2.16; p< 0.001).
After adjustment for age, gender identity, and race/ethnicity, the magnitude of association was attenuated but remained significant. In fully adjusted models accounting for demographics, income, and perceived stress, ADHD remained independently associated with food insecurity (ADHD without medication OR=1.51, 95% CI 1.28–1.78; ADHD with medication OR=1.39, 95% CI 1.27–1.51). Medication status was not significantly associated with food insecurity among individuals with ADHD.
Income demonstrated a strong gradient effect, with high income significantly protective compared to low income (OR=0.61, 95% CI 0.59–0.64). Perceived stress was also independently associated with food insecurity. Interaction analyses between ADHD status and income did not demonstrate substantial effect modification, suggesting that the association between ADHD and food insecurity was relatively consistent across income levels.
CONCLUSION
ADHD is independently associated with increased odds of food insecurity, even after adjustment for demographic, socioeconomic, and psychosocial factors. Income and stress are dominant structural determinants, though disparities persist among individuals with ADHD. Further longitudinal studies are warranted to clarify causal pathways and the potential protective role of treatment.
Embargo Period
5-28-2026
Included in
ADHD and Food Insecurity: The Role of Structural Determinants
Moultrie, GA
INTRODUCTION
Food insecurity is a key structural determinant of health associated with adverse physical and psychological outcomes. Individuals with attention-deficit/hyperactivity disorder (ADHD) may be particularly vulnerable due to executive dysfunction, psychosocial stress, and socioeconomic instability. The association between ADHD status, medication use, and food insecurity, however, has not been well characterized in large national cohorts.
OBJECTIVE
To evaluate the association between ADHD status (with and without medication) and food insecurity in the All of Us Research Program cohort.
METHODS
We conducted a cross-sectional analysis of 142,725 eligible participants from the All of Us Research Program. ADHD status was categorized as ADHD with medication, ADHD without medication, and no ADHD (reference group). The primary outcome was self-reported food insecurity. Group differences in food insecurity by ADHD status were assessed using chi-square tests. Multivariable logistic regression models were then used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for food insecurity. Sequential models were constructed: (1) unadjusted; (2) adjusted for age, gender identity, and race/ethnicity; and (3) fully adjusted for age, gender identity, race/ethnicity, income category, and perceived stress. To assess potential effect modification, interaction terms between ADHD status and income were included. A sensitivity analysis restricted to participants with ADHD was performed to examine the association between medication status and food insecurity.
RESULTS
Food insecurity was reported in 21,546 participants. Chi-square analyses demonstrated significant differences in food insecurity prevalence across ADHD groups (p< 0.001). In unadjusted logistic regression models, both ADHD groups had increased odds of food insecurity compared to controls (ADHD without medication OR=2.35, 95% CI 2.04–2.71; ADHD with medication OR=2.00, 95% CI 1.85–2.16; p< 0.001).
After adjustment for age, gender identity, and race/ethnicity, the magnitude of association was attenuated but remained significant. In fully adjusted models accounting for demographics, income, and perceived stress, ADHD remained independently associated with food insecurity (ADHD without medication OR=1.51, 95% CI 1.28–1.78; ADHD with medication OR=1.39, 95% CI 1.27–1.51). Medication status was not significantly associated with food insecurity among individuals with ADHD.
Income demonstrated a strong gradient effect, with high income significantly protective compared to low income (OR=0.61, 95% CI 0.59–0.64). Perceived stress was also independently associated with food insecurity. Interaction analyses between ADHD status and income did not demonstrate substantial effect modification, suggesting that the association between ADHD and food insecurity was relatively consistent across income levels.
CONCLUSION
ADHD is independently associated with increased odds of food insecurity, even after adjustment for demographic, socioeconomic, and psychosocial factors. Income and stress are dominant structural determinants, though disparities persist among individuals with ADHD. Further longitudinal studies are warranted to clarify causal pathways and the potential protective role of treatment.