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Analysis Of The National Health And Nutrition Examination Survey

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Publicly available data from three waves 2009-2010, 2011-2012, and 2013-2014 of the National Health and Nutrition Examination Survey (NHANES) were used for this analysis. These waves were selected because they correspond to the most recent time periods with available data for public use at the time of this analysis between 2017-2018. NHANES is a repeated, cross-sectional survey with a multi-stage probability sample of non-institutionalized population of the United States.27 Demographic variables including country of birth, citizenship status, and household food security variables were collected using the Continuous NHANES questionnaire. Detailed data collection methods can be found in the NHANES website …show more content…

Exposure Assessment Self-reported citizenship status and years in the US were combined into one single variable with three categories: (i) U.S. citizen born in the U.S. or other U.S. territory such as Puerto Rico, Guam, American Virgin Islands, or born abroad to American parents; (ii) U.S. citizen, foreign born, citizen by way of naturalization; (iii) Non-U.S. citizen foreign born. Non-US citizen foreign born refers to any individual that is not a U.S. citizen at birth and who has not gone through the naturalization immigration process. This may include lawful permanent residents (LPRs), temporary migrants, humanitarian migrants such as refugees and asylees, and unauthorized migrants. This NHANES sample includes data from foreign born who partake in the census independent of legal status.28 Outcome Assessment The 10 item US Household Food Security Module, developed and validated by the US Department of Agriculture, was utilized as part of the Continuous NHANES Questionnaire to measure adult food security status over the prior 12 months. Adult food security status was categorized as full food security, marginal food security, low food security, and very low food security.27 Covariate Assessment Demographic data was obtained by trained interviewers using the Computer-Assisted Personal Interview (CAPI) system.27 Covariates included individual characteristics known to be associated with citizenship status and food insecurity. Additionally, directed acyclic causal

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