Published online December 31, 2007
PEDIATRICS Vol. 121 No. 1 January 2008, pp. 65-72 (doi:10.1542/peds.2006-3717)
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ARTICLE

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

Ruth Rose-Jacobs, ScDa, Maureen M. Black, PhDb, Patrick H. Casey, MDc, John T. Cook, PhDa, Diana B. Cutts, MDd, Mariana Chilton, PhD, MPHe, Timothy Heeren, PhDf, Suzette M. Levenson, MEd, MPHg, Alan F. Meyers, MD, MPHa and Deborah A. Frank, MDa

a Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
b Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
c Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
d Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota
e Department of Community Health Prevention, Drexel University School of Public Health, Philadelphia, Pennsylvania
f Department of Biostatistics
g Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts

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.

Key Words: child development • infant • child • preschool • child nutrition • hunger • early intervention • risk factors

Abbreviations: FI—food insecurity • PEDS—Parents' Evaluations of Developmental Status

Accepted Jun 19, 2007.