Objective: To examine the relationship between social risk factors (housing instability and food insecurity) on health-related quality of life (HRQoL) in women with a previous diagnosis of gestational diabetes mellitus (GDM) .
Methods: Cross-sectional data on women aged 18 and older from the Behavioral Risk Factor Surveillance System (2014, 2015, 2017) were analyzed. GDM was defined by self-reported diagnosis of diabetes only during pregnancy. Social risks were defined by experiences of housing instability or food insecurity within the previous year. Linear regression was run to evaluate the association between social risks and HRQoL controlling for sociodemographic confounders. Interaction terms between each social risk factor and race/ethnicity were tested for each outcome but were not significant, thus the analysis was not stratified.
Results: Among the total study sample (weighted N=3,080,442) of adult women with a prior GDM diagnosis, 14.8% and 12.6% reported recent housing instability and food insecurity, respectively. Among women with prior GDM, housing instability was associated with reduced self-rated general health status (-0.36; 95%CI -0.53, -0.19) and increased days of poor mental health (4.81; 95%CI 1.23, 8.39) . Food insecurity was associated with reduced self-rated general health status (-0.43, 95%CI -0.59, -0.27) and increased days of poor mental health (5.29; 95%CI 1.95, 8.64) .
Conclusion: Our findings indicate an inverse association between food insecurity and housing instability and self-rated general health status and mental health functioning among women with a prior GDM diagnosis. There was no differential relationship by race/ethnicity. These findings highlight the importance of interventions which address social risks to improve quality of life in women with a prior GDM diagnosis.
S.L.Walker: None. R.J.Walker: None. L.Hawks: None. E.Mosley-johnson: None. S.Nagavally: None. L.E.Egede: None.
American Diabetes Association (1-19-JDF-075) ; National Institute of Diabetes and Digestive Kidney Disease (K24DK093699, R01DK118038, R01DK120861, PI: Egede) , the National Institute for Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker)