title: Household food insecurity: associations with at-risk infant and toddler development.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, 91 East Concord St, Room 5106, Boston, MA 02118, USA. rrosejac@bu.edu
authors.forename: Ruth
authors.initials: R
authors.lastname: Rose-Jacobs
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Casey
authors.forename: John T
authors.initials: JT
authors.lastname: Cook
authors.forename: Diana B
authors.initials: DB
authors.lastname: Cutts
authors.forename: Mariana
authors.initials: M
authors.lastname: Chilton
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.forename: Suzette M
authors.initials: SM
authors.lastname: Levenson
authors.forename: Alan F
authors.initials: AF
authors.lastname: Meyers
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Frank
mesh_terms: D017028:Caregivers; D002657:Child Development / Q000502:physiology; D002669:Child Welfare; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology*; D005191:Family Characteristics; D005260:Female; D005523:Food Supply / Q000191:economics*; D006801:Humans; D006815:Hunger; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009751:Nutritional Requirements; D011203:Poverty; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States