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April 24, 2026Frontiers in Public Health3 citationsOpen Access

Health insurance participation may mitigate the health impact of food insecurity among Chinese working-age adults

KXKaiyin XuFMF. K. MenYFYuxuan Fan

Key Points

  • This research investigates how health insurance participation affects health outcomes related to food insecurity among working-age adults in China.
  • Analyzed cross-sectional survey data from 4,795 individuals aged 30–60 in three Chinese provinces.
  • Assessed food insecurity using the FAO's Food Insecurity Experience Scale (FIES).
  • Examined associations between food insecurity, chronic conditions, mental disorders, and healthcare utilization.
  • Food insecurity was positively associated with increased reports of chronic conditions, mental disorders, and doctor visits.
  • Health insurance participation lessened the negative health impacts of food insecurity.
  • Several factors, including healthcare accessibility and dietary quality, partially mediated the relationship between food insecurity and health outcomes.

Abstract

In mainland China, approximately 250 million people are unable to afford healthy meals. Food insecurity has been linked to poorer health outcomes in western countries, yet its impact remains understudied in China, especially among working-age adults. We analyzed cross-sectional data from an online survey conducted in 2024 with 4,795 individuals aged 30–60 from three Chinese provinces. Respondents self-reported chronic conditions, mental disorders, disabilities, and doctor visits. Household food insecurity was assessed by the FAO’s Food Insecurity Experience Scale (FIES). The results showed that food insecurity was positively associated with chronic conditions, mental disorders, disabilities, and doctor visits in a dose–response fashion after confounders adjustment. Health insurance participation mitigated the association of food insecurity with chronic conditions and doctor visits. Healthcare accessibility, dietary quality, social support, and psychological chronic stress partially mediated the food insecurity-health relationship. Efforts to broaden and upgrade health insurance coverage and promote healthcare accessibility may help reduce health inequity across food security levels.

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Cite This Study

Xu et al. (2026) studied this question.

synapsesocial.com/papers/69eb07a4553a5433e34b32behttps://doi.org/10.3389/fpubh.2026.1808940
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