To characterize differences in physical health and food security among people with epilepsy (PWE) compared to the general population using national survey data.

Epilepsy is known to be associated with multiple medical co-morbidities and economic disparities, but the magnitude of these associations is incompletely characterized. 

Using 2013–2018 Center for Disease Control and Prevention, National Health and Nutrition Examination Survey (NHANES) Data, PWE were identified through their reported anti-seizure medication use, and matched to controls by age, gender, and race in the same dataset. Variables compared included physical activity, disability, hospital utilization, associated medical conditions, and food security.

150 PWE (50% male; median age 53) were matched with 6,750 controls (50% male; median age 53), with no significant racial differences. Compared with controls, more PWE rated their health as “Fair/Poor” (52.0% vs. 25.7%), reported difficulty walking (42.0% vs. 17.5%), and used walking aids (38.2% vs. 13.9%) (p < 0.001). Participation in moderate (24.7% vs. 38.9%) and vigorous (14.0% vs. 21.0%) recreational activities was lower among PWE (p<0.04). PWE also had more overnight hospitalizations in the last year (22.0% vs. 11.4%) and were more likely to have had ≥13 healthcare visits in the past year (22.7% vs. 6.1%) (p<0.001). Among >15 co-morbidities analyzed, PWE were somewhat more likely to report COPD, emphysema, heart attack, heart failure, and anemia (differences 4.4 – 6.9%). Food insecurity was higher among PWE,  including greater lifetime reliance on  SNAP/FS benefits (53.7% vs. 37.5%),  frequent inability to afford balanced meals (13.5% vs. 6.9%), hunger due to cost in the last year (34.4% vs. 22.4%), and use of emergency food services in the last year (25.0% vs. 12.0%) (p<0.01).

PWE experience poorer physical health, have more hospitalizations and healthcare visits, and higher rates of food insecurity, underscoring substantial disparities compared to the general population.