LAUSR

OBJECTIVE To examine the association between language use - predominantly English, English and Spanish equally, and predominantly Spanish - and food insecurity among Hispanic adults residing in the United States, 1999-2018. DESIGN Pooled cross-sectional study design. SETTING United States. PARTICIPANTS 15,073 Hispanic adults. RESULTS Compared to Hispanic adults who predominantly spoke English and after adjusting for age, sex, family income-to-poverty ratio, education level, and employment status, Hispanic adults who spoke English and Spanish equally (OR=1.28, 95%CI=1.05-1.56) or predominantly Spanish (OR=1.25, 95%CI=1.04-1.49) had higher odds of food insecurity. After stratifying by country of birth, language use was associated with higher odds of food insecurity only for Hispanic adults born outside of the United States, but not for Hispanic adults born in the United States. Hispanic adults born outside of the United States who spoke English and Spanish equally (OR=1.27, 95%CI=1.04-1.55) or spoke predominantly Spanish (OR=1.24, 95%CI=1.04-1.48) had higher odds of food insecurity when compared to those who predominantly spoke English. CONCLUSION Foreign-born Hispanic adults who speak predominantly Spanish, or English and Spanish equally, have higher odds of food insecurity. Food and nutrition assistance programs that serve Hispanic immigrants should make sure to provide linguistically- and culturally appropriate services to this population.