title: Relationship of household food insecurity to neonatal, infant, and under-five child mortality among families in rural Indonesia.
abstract: BACKGROUND
  Food insecurity is common in developing countries and is related to the physical well-being of families. Household food insecurity is intended to reflect a household's access, availability, and utilization of food, but its relationship with child mortality has not been well characterized.
  
  
  OBJECTIVE
  To examine the relationship of a modified household food insecurity score with a history of neonatal, infant, and under-five child mortality.
  
  
  METHODS
  In a cross-sectional study of 26,339 rural households in the Indonesian Nutrition Surveillance System, 2000-03, household food insecurity was measured with the use of a modified nine-item food security questionnaire. A simple food insecurity score of O to 9 was calculated based on responses and related to mortality history in the family.
  
  
  RESULTS
  The proportion of households with neonatal, infant, and under-five child mortality was 4.6%, 8.8%, and 10.6%, respectively. In households with and without neonatal, infant, and under-five child mortality, the mean (+/- SD) food insecurity scores were 2.19 +/- 1.89 vs. 1.72 +/- 1.65, 2.29 +/- 1.94 vs. 1.69 +/- 1.63, and 2.29 +/- 1.93 vs. 1.68 +/- 1.62 (all p < .0001), respectively. The food insecurity score was related to mortality among neonates (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02 to 1.09; p = .003), infants (OR, 1.06; 95% CI, 1.03 to 1.09; p < .0001), and children under five (OR, 1.07; 95% CI, 1.04 to 1.10; p < .0001) after adjustment for potential confounders.
  
  
  CONCLUSIONS
  Higher household food insecurity score is associated with greater neonatal, infant, and under-five child mortality among rural families in Indonesia. Greater household food insecurity may signify a higher risk of infant and young child mortality.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Campbell
authors.forename: Saskia
authors.initials: S
authors.lastname: de Pee
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Klaus
authors.initials: K
authors.lastname: Kraemer
authors.forename: Andrew
authors.initials: A
authors.lastname: Thorne-Lyman
authors.forename: Regina
authors.initials: R
authors.lastname: Moench-Pfanner
authors.forename: Mayang
authors.initials: M
authors.lastname: Sari
authors.forename: Nasima
authors.initials: N
authors.lastname: Akhter
authors.forename: Martin W
authors.initials: MW
authors.lastname: Bloem
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
mesh_terms: D000328:Adult; D046688:Child Mortality; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012423:Rural Health; D012959:Socioeconomic Factors