Skip to main content

Advertisement

SpringerLink
Log in

Frequency of Food Insecurity and Associated Health Outcomes in Pediatric Patients at a Federally Qualified Health Center

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Food insecurity (FI) has been recognized as a public challenge not only for developing countries but also for the U.S. population. The present study was designed to identify the prevalence of FI and the association of household FI with the health status of pediatric patients seen at a Federally Qualified Health Center in New Jersey which provides health care mainly for Latino patients. Patients were included if they were screened for FI at their well visits during a 4-month period following implementation of the 2-item screening tool recommended by American Academy of Pediatrics. We compared demographic and morbidity data of children with FI to those living in food-secure households. The results are presented as the distribution of frequency (%) and odds ratios (OR) with 95% confidence interval (95% CI). FI was detected in 15.8% (95% CI 14.2–17.5%) of 486 studied children. We recorded higher rates of anemia (10.4 vs. 3.2%, p < 0.005), hypercholesterolemia (10.4 vs. 3.4%, p < 0.01), and any morbidity (24.7 vs. 9.3%, p < 0.02) in children living in FI households. Multivariate logistic regression analysis revealed an association of household FI with at least one recorded morbidity independent of the patient’s age, gender, and body mass index (OR 1.79, 95% CI 1.31–2.43). No one was diagnosed with diabetes, and only a few with asthma and hypertension. We have concluded that living in households with FI increased the risk for unfavorable health outcomes in a predominantly economically disadvantage community of children within the U.S. population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Coleman-Jensen, A., Rabbitt, M. P., Gregory, C. A., & Singh, A. (2017). Household Food Security in the United States in 2016. ERR-237, U.S. Department of Agriculture, Economic Research Service.

  2. Schanzenbach, D. W., & Baurer, L. (2017). Food Insecurity Among Children in 2015. Retrieved November 28, 2017 from https://www.brookings.edu/blog/up-front/2017/06/19/food-insecurity-among-children-in-2015/.

  3. Gundersen, C., & Gundersen, C. (2015). Food insecurity and health outcomes. Health Affairs, 34(11), 1830–1839.

    Article  PubMed  Google Scholar 

  4. Schwarzenberg, S. J., Kuo, A. A., Linton, J. M., & Flanagan, P. (2015). Promoting food security for all children. Pediatrics, 136(5), e1431–e1438. https://doi.org/10.1542/peds.2015-3301.

    Article  Google Scholar 

  5. Department of Agriculture, Economic Research Service and Food and Nutrition Service. (2017). Percentage of children ages 0–17 in food insecure households by selected characteristics and severity of food insecurity, selected years 1995–2015. Retrieved November 28, 2017 from https://www.childstats.gov/americaschildren/tables/econ3.asp.

  6. Gundersen, C., Dewey, A., Crumbaugh, A. S., Kato, M., & Engelhard, E. (2017). Map the Meal Gap 2017: Food Insecurity and child food insecurity estimates at the county level. Feeding America. Retrieved November 17, 2017 from http://www.feedingamerica.org/research/map-the-meal-gap/2015/2015/-mapthemealgap-exec-summary.pdf.

  7. Quandt, S. A., Shoaf, J. I., Tapia, J., Hernandez-Pelletier, M., Clark, H. M., & Arcury, T. A. (2006). Experiences of Latino immigrant families in North Carolina help explain elevated levels of food insecurity and hunger. Journal of Nutrition, 136(10), 2638–2644.

    Article  PubMed  CAS  Google Scholar 

  8. Gundersen, C., Garasky, S., & Lohman, B. J. (2009). Food insecurity is not associated with childhood obesity as assessed using multiple measures of obesity. Journal of Nutrition, 139(6), 1173–1178.

    Article  PubMed  CAS  Google Scholar 

  9. Banach, L. P. (2016). Hospitalization: Are we missing an opportunity to identify food insecurity in children? Academic Pediatrics, 16(5), 438–445.

    Article  PubMed  Google Scholar 

  10. Cook, J. T., Frank, D. A., Berkowitz, C., Black, M. M., Casey, P. H., Cutts, D. B., … Nord, M. (2004). Food insecurity is associated with adverse health outcomes among human infants and toddlers. Journal of Nutrition, 134(6), 1432–1438.

    Article  PubMed  CAS  Google Scholar 

  11. Bright, M. A., Thompson, L., Esernio-Jenssen, D., Alford, S., & Shenkman, E. (2015). Primary care pediatricians’ perceived prevalence and surveillance of adverse childhood experiences in low-income children. Journal of Health Care for the Poor and Underserved, 26(3), 686–700.

    Article  PubMed  Google Scholar 

  12. McLoyd, V. C. (1998). Socioeconomic disadvantage and child development. American Psychologist, 53(2), 185–204.

    Article  PubMed  CAS  Google Scholar 

  13. Hager, E., Quigg, A., Black, M., Coleman, S., Heeren, T., Rose-Jacobs, R., … Frank, D. (2010). Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics, 126(1), E26–E32.

    Article  PubMed  Google Scholar 

  14. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. (2015). About child and teen BMI. Retrieved November 5, 2017 from https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html.

  15. Carbarski, D. (2014). Comparing self and maternal reports of adolescents’ general health in a nationally representative survey: Do self and proxy reports differ in their relationships with covariates? Quality of Life Research, 23(7), 1953–1965.

    Article  Google Scholar 

  16. Alaimo, K., Olson, C., Frongillo, E., & Briefel, R. (2001). Food insufficiency, family income, and health in US preschool and school-aged children. The American Journal of Public Health, 91(5), 781–786.

    Article  PubMed  CAS  Google Scholar 

  17. Garg, A., Toy, S., Tripodis, Y., Silverstein, M., & Freeman, E. (2015). Addressing social determinants of health at well child care visits: A cluster RCT. Pediatrics, 135(2), 296–304.

    Article  Google Scholar 

  18. Park, K., Kersey, M., Geppert, J., Story, M., Cutts, D., & Himes, J. H. (2009). Household food insecurity is a risk factor for iron-deficiency anaemia in a multi-ethnic, low-income sample of infants and toddlers. Public Health Nutrition, 12(11), 2120–2129.

    Article  PubMed  Google Scholar 

  19. Trapp, C. M., Burke, G., & Gorin, A. A. (2015). The relationship between dietary patterns, body mass index percentile, and household food security in young urban children. Child Obesity, 11(2), 148–155.

    Article  Google Scholar 

  20. Metallinos-Katsaras, E., Must, A., & Gorman, K. (2012). A longitudinal study of food insecurity on obesity in preschool children. Journal of the Academy of Nutrition and Dietetics, 112(12), 1949–1958.

    Article  PubMed  Google Scholar 

  21. Skalicky, A., Meyers, A. F., Adams, W. G., Yang, Z., Cook, J. T., & Frank, D. A. (2006). Child food insecurity and iron deficiency anemia in low-income infants and toddlers in the United States. Maternal and Child Health Journal, 10(2), 177–185.

    Article  PubMed  Google Scholar 

  22. Gundersen, G., & Ziliak, J. P. (2015). Food insecurity and health outcomes. Health Affairs, 34(11), 1830–1839.

    Article  PubMed  Google Scholar 

  23. Marjerrison, S., Cummings, E. A., Glanville, N. T., Kirk, S. F., & Ledwell, M. (2011). Prevalence and associations of food insecurity in children with diabetes mellitus. Journal of Pediatrics, 158(4), 607–611.

    Article  PubMed  Google Scholar 

  24. To, Q. G., Frongillo, E. A., Gallegos, D., & Moore, J. B. (2014). Household food insecurity is associated with less physical activity among children and adults in the U.S. Journal of Nutrition, 144(11), 1797–1802.

    Article  PubMed  CAS  Google Scholar 

  25. Hagan, J. F., Shaw, J. S., & Duncan, P. M. (2017). Bright futures: Guidelines for health supervision of infants, children, and adolescents. American Academy of Pediatrics. Retrieved November 28, 2017 from https://pediatriccare.solutions.aap.org/book.aspx?bookid=990.

  26. Bolton, P., Holt, E., Ross, A., Hughart, N., & Guyer, B. (1998). Estimating vaccination coverage using parental recall, vaccination cards, and medical records. Public Health Reports, 113(6), 521–526.

    PubMed  PubMed Central  CAS  Google Scholar 

  27. Anderson, S. A. (1990). Core indicators of nutritional state for difficult-to-sample populations. Journal of Nutrition, 120(suppl 11), 1557S–1600S.

    Google Scholar 

  28. Bickel, G., Nord, M., Price, C., Hamilton, W., & Cook, J. T. (2000). Measuring Food Security in the United States: Guide to Measuring Household Food Security. USDA. Retrieved November 28, 2017 from http://www.fns.usda.gov/guidmeasuring-household food security.

  29. Lee, J. S., Gundersen, C., Cook, J., Laria, B., & Johnson, M. A. (2012). Food insecurity and health across the lifespan. Advances in Nutrition, 3(5), 744–745.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Nord, M. (2009). Food spending declined and food insecurity increased for middle-income and low-income households from 2000 to 2007. Economic Information Bulletin (EIB), 61, 1–16.

    Google Scholar 

  31. Fram, M. S., Frongillo, E. A., Draper, C. L., & Fishbein, E. (2012). Development and validation of a child report assessment of child food insecurity and comparison to parent report assessment. Journal of Hunger and Environment Nutrition, 8(2), 128–145.

    Article  Google Scholar 

  32. Casey, P. H., Szeto, K., Lenzing, S., Bogle, M., & Weber, J. (2001). Children in food-insufficient, low-income families: Prevalence, health, and nutrition status. Archives of Pediatrics & Adolescent Medicine, 155(4), 508–514.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors wish to acknowledge the physicians, pediatric residents, and nurses who all contributed to the implementation of food insecurity screening of pediatric patients at the Eric B. Chandler Health Center in New Brunswick, NJ. We are indebted to the parents and children whose medical records were used in this study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Medical Education Building 308, New Brunswick, NJ, 08903, USA

    Kandy Bahadur, Shilpa Pai, Estherline Thoby & Anna Petrova

Authors
  1. Kandy Bahadur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shilpa Pai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Estherline Thoby
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Petrova
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kandy Bahadur.

Ethics declarations

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The corresponding author wrote the first draft of the manuscript and it has been edited and approved by all authors.

Disclosure

There are no prior publications or submissions with any overlapping information, including studies and patients. The authors have no financial relationships relevant to this article to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bahadur, K., Pai, S., Thoby, E. et al. Frequency of Food Insecurity and Associated Health Outcomes in Pediatric Patients at a Federally Qualified Health Center. J Community Health 43, 896–900 (2018). https://doi.org/10.1007/s10900-018-0499-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-018-0499-8

Keywords

Search

Navigation