Food insecurity is recognized as a serious public health problem worldwide. Since household food security may affect health-related quality of life, the present study was carried out to assess associations of household food security with health-related quality of life in various districts of Tehran, Iran.

Data of this cross-sectional study were collected from the Urban Health Equity Assessment and Response Tool (Urban HEART-2) Survey in Tehran Capital City, Iran, 2011, using multistage cluster random sampling method. From each household, one person was selected to participate. Data collection instruments included 6-item short-form to measure household food security status and SF-12V2 questionnaire to evaluate health-related quality of life. From 33252 people, 30521 people with ages of 18 years or greater were included in this study. Multiple linear regression model was used to assess independent effects of household food security on health-related quality of life.

Age range of the participants was 18–90 years with a mean age of 43.85 years ±16.2. Overall, 68.4% of the participants were female and 35.2% were male. Moreover, 62.2% of the participating households belonged to the food secure group. The mean score of the health-related quality of life was 60.5 ±19.4. The mean scores of health-related quality of life varied based on the household food security status in various districts of Tehran (p < 0.001). Multiple linear regression model showed significant relationships between health-related quality of life and household food security, adjusting age, gender, education, marital status, family size, body mass index and wealth and deprivation indices
(p < 0.001).

Results showed associations of the household food security with health-related quality of life in various districts of Tehran. Policy makers are recommended to provide efficient interventions to promote quality of life of urban households based on the social determinants in each district.