Household Food Insecurity: Associations With At-Risk Infant and Toddler Development

Department of Pediatrics, Boston University School of Medicine, 91 East Concord St, Room 5106, Boston, MA 02118, USA.
PEDIATRICS (Impact Factor: 5.47). 02/2008; 121(1):65-72. DOI: 10.1542/peds.2006-3717
Source: PubMed


In this study, we evaluated the relationship between household food security status and developmental risk in young children, after controlling for potential confounding variables.
The Children's Sentinel Nutritional Assessment Program interviewed (in English, Spanish, or Somali) 2010 caregivers from low-income households with children 4 to 36 months of age, at 5 pediatric clinic/emergency department sites (in Arkansas, Massachusetts, Maryland, Minnesota, and Pennsylvania). Interviews included demographic questions, the US Food Security Scale, and the Parents' Evaluations of Developmental Status. The target child from each household was weighed, and weight-for-age z score was calculated.
Overall, 21% of the children lived in food-insecure households and 14% were developmentally "at risk" in the Parents' Evaluations of Developmental Status assessment. In logistic analyses controlling for interview site, child variables (gender, age, low birth weight, weight-for-age z score, and history of previous hospitalizations), and caregiver variables (age, US birth, education, employment, and depressive symptoms), caregivers in food-insecure households were two thirds more likely than caregivers in food-secure households to report that their children were at developmental risk.
Controlling for established correlates of child development, 4- to 36-month-old children from low-income households with food insecurity are more likely than those from low-income households with food security to be at developmental risk. Public policies that ameliorate household food insecurity also may improve early child development and later school readiness.

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    • "Understanding which cumulative family risk index contributes to different levels of food insecurity may help public and private administrators of food assistance programs decide whether other forms of social services need to be connected with food assistance program participation. The linking of established social services to already existing food assistance programs may help prevent young children from experiencing the negative health and developmental consequences of residing in food insecure households (Bronte-Tinkew et al., 2007; Cook et al., 2004, 2006; Hernandez and Jacknowitz, 2009; Park et al., 2009; Perez-Escamilla and Pinheiro de Toledo Vianna, 2012; Rose-Jacobs et al., 2008; Skalicky et al., 2006; Whitaker et al., 2006; Zaslow et al., 2009). "
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    ABSTRACT: The study uses the Fragile Families and Child Well-being Study (N = 2025) to examine the relationship between four cumulative family risk indices and refined measures of food hardship: marginal food security, low food security, and very low food security. Regression analyses indicate that cumulative family risk indices are useful in differentiating various levels of food insecurity. Specifically, the maternal poor health and risky health behaviors index is pertinent for distinguishing (1) food insecure from marginal food secure households and (2) very low food secure from low food secure households. In addition, the financial strain index is pertinent for differentiating between marginal food secure families from food secure families among non-poor households. Connecting food assistance programs with established social services may decrease the negative impact that cumulative family-level risk factors have on families’ varying levels of food insecurity.
    No preview · Article · Mar 2015 · Social Science Research
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    • "In Western countries, the health risks associated with food insecurity in children have been found to include, for example, greater odds of having health reported as “fair/poor” (vs. “excellent/good”), greater odds of hospitalisation since birth, increased rates of acute and chronic illness, lower health-related quality of life and experiencing more health complaints such as stomach aches and headaches (3,7,12–14). However, the relationships between food insecurity and children's health, behavior and development seem to vary according to the child's age, gender and ethnicity (7,13,15–17). "
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    ABSTRACT: In vulnerable populations, food security in children has been found to be associated with negative health effects. Still, little is known about whether the negative health effects can be retrieved in children at the population level. To examine food insecurity reported by Greenlandic school children as a predictor for perceived health, physical symptoms and medicine use. The study is based on the Greenlandic part of the Health Behavior in School-aged Children survey. The 2010 survey included 2,254 students corresponding to 40% of all Greenlandic school children in Grade 5 through 10. The participation rate in the participating schools was 65%. Food insecurity was measured as going to bed or to school hungry because there was no food at home. Boys, the youngest children (11-12 year-olds), and children from low affluence homes were at increased risk for food insecurity. Poor or fair self-rated health, medicine use last month and physical symptoms during the last 6 months were all more frequent in children reporting food insecurity. Controlling for age, gender and family affluence odds ratio (OR) for self-rated health was 1.60 (95% confidence interval (CI 1.23-2.06) (p<0.001), for reporting physical symptoms 1.34 (95% CI 1.06-1.68) (p=0.01) and for medicine use 1.79 (95% CI 1.42-2.26) (p<0.001). Stratification on age groups suggested that children in different age groups experience different health consequences of food insecurity. The oldest children reported food insecurity less often and experienced less negative health effects compared to the younger children. All 3 measures of health were negatively associated to the occurrence of food insecurity in Greenlandic school children aged 11-17. Food security must be seen as a public health issue of concern, and policies should be enforced to prevent food poverty particularly among boys, younger school children and children from low affluence homes.
    Full-text · Article · Aug 2013
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    • "It is difficult to say with certainty that all household members experience food insecurity in the same capacity, especially considering that mothers may not be fully aware of children’s experiences, resourcefulness, and actions taken to reduce the severity of food insecurity. As children who are food insecure often have poorer nutritional, educational, cognitive, developmental, and social outcomes compared to food secure children [5,11-15], measuring food insecurity in children, as reported by children, is an important next step in food security research. "
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    ABSTRACT: Background Food insecurity is associated with detrimental physical, psychological, behavioral, social, and educational functioning in children and adults. Greater than one-quarter of all Hispanic households in the U.S. are food insecure. Hispanic families in the U.S. comprise 30% of households with food insecurity at the child level, the most severe form of the condition. Methods Food security discordance was evaluated among 50 Mexican-origin children ages 6–11 and their mothers living in Texas border colonias from March to June 2010. Mothers and children were interviewed separately using promotora-researcher administered Spanish versions of the Household Food Security Survey Module and the Food Security Survey Module for Youth. Cohen’s kappa statistic (κ) was used to analyze dyadic agreement of food security constructs and level of food security. Results Eighty percent of mothers reported household food insecurity while 64% of children identified food insecurity at the child level. There was slight inter-rater agreement in food security status (κ = 0.13, p = 0.15). Poor agreement was observed on the child hunger construct (κ = −0.06, p = 0.66) with fair agreement in children not eating for a full day (κ = 0.26, p < 0.01) and relying on low-cost foods (κ = 0.23, p = 0.05). Conclusions Mother and child-reported household and child-level food insecurity among this sample of limited-resource Mexican-origin colonias residents far surpass national estimates. While the level of dyadic agreement was poor, discordance may be attributable to parental buffering, social desirability in responses, and/or the age of children included in the present analysis. Future research should continue to explore how food security is understood from the perspectives and experiences of children and adolescents.
    Full-text · Article · Jan 2013 · Nutrition Journal
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