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Symposium: Food Assistance and the Well-Being of Low-Income Families

Child Food Insecurity Increases Risks Posed by Household Food Insecurity to Young Children's Health^1,2

John T. Cook³, Deborah A. Frank, Suzette M. Levenson^*, Nicole B. Neault, Tim C. Heeren, Maurine M. Black^**, Carol Berkowitz, Patrick H. Casey, Alan F. Meyers, Diana B. Cutts and Mariana Chilton^#

Department of Pediatrics, Boston University School of Medicine, Boston, MA 02118; ^* Data Coordinating Center and Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118; ^** Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201; Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles, CA 90509; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202; Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN 55415; and ^# Department of Community Health and Prevention, Drexel University School of Public Health, Philadelphia, PA 19102

³ To whom correspondence should be addressed. E-mail: john.cook{at}bmc.org.

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.

KEY WORDS: • household food security • child food security • child health • food stamps

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