Underrated risk: Food insecurity and distress of Filipino Americans with hypertension in a primary care setting

Background: Filipino Americans experience disproportionately high rates of hypertension and remain understudied in health disparities research. Although food insecurity (FI) is a recognized social determinant of health, its influence on psychological distress and chronic illness in this population is not well understood. Purpose: This study examined the relationship between FI and psychological distress among Filipino Americans with hypertension, guided by an adapted Minority Stress Model. Methodology: A cross-sectional, descriptive, correlational study was conducted with 135 Filipino American adults recruited from a primary care clinic in Southern Nevada. Participants completed validated instruments assessing both FI and psychological distress. FI was measured using a standardized FI scale, whereas psychological distress was assessed using the Distress Thermometer and Problem List. Data were analyzed using multivariate logistic regression and nonparametric tests. Results: Income level was the only demographic variable significantly associated with FI ( p = .0002). Food-insecure participants reported higher distress (median score = 4) than food-secure peers (median score = 2, p < .001). After adjusting for age, gender, and income, FI remained strongly associated with sleep problems (OR = 3.4, p = .008), worry (OR = 3.83, p = .009), and sadness (OR = 3.85, p = .02). No significant associations were found between FI and other physical symptoms. Conclusions: Food insecurity is a critical psychosocial stressor linked to increased psychological distress among Filipino Americans with hypertension. Implications: Nurse practitioners and primary care providers should incorporate culturally responsive, community-engaged approaches when screening for both FI and psychological distress in this population.