ABSTRACT
OBJECTIVES: In this study, we evaluated the relationship between household food security status and developmental risk in young children, after controlling for potential confounding variables. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Subject(s)
Child Welfare , Developmental Disabilities/epidemiology , Developmental Disabilities/etiology , Food Supply/economics , Poverty , Caregivers , Child Development/physiology , Child, Preschool , Confounding Factors, Epidemiologic , Cross-Sectional Studies , Family Characteristics , Female , Humans , Hunger , Infant , Logistic Models , Male , Multivariate Analysis , Nutritional Requirements , Risk Factors , Socioeconomic Factors , Surveys and Questionnaires , United StatesABSTRACT
The US Food Security Scale (USFSS) measures household and child food insecurity (CFI) separately. Our goal was to determine whether CFI increases risks posed by household food insecurity (HFI) to child health and whether the Food Stamp Program (FSP) modifies these effects. From 1998 to 2004, 17,158 caregivers of children ages 36 mo were interviewed in six urban medical centers. Interviews included demographics, the USFSS, child health status, and hospitalization history. Ten percent reported HFI, 12% HFI and CFI (H&CFI). Compared with food-secure children, those with HFI had significantly greater adjusted odds of fair/poor health and being hospitalized since birth, and those with H&CFI had even greater adverse effects. Participation in the FSP modified the effects of FI on child health status and hospitalizations, reducing, but not eliminating, them. Children in FSP-participating households that were HFI had lower adjusted odds of fair/poor health [1.37 (95% CI, 1.06-1.77)] than children in similar non-FSP households [1.61 (95% CI, 1.31-1.98)]. Children in FSP-participating households that were H&CFI also had lower adjusted odds of fair/poor health [1.72 (95% CI, 1.34-2.21)] than in similar non-FSP households [2.14 (95% CI, 1.81-2.54)]. HFI is positively associated with fair/poor health and hospitalizations in young children. With H&CFI, odds of fair/poor health and hospitalizations are even greater. Participation in FSP reduces, but does not eliminate, effects of FI on fair/poor health.
