Relationship of household food insecurity to neonatal, infant, and under-five child mortality among families in rural Indonesia.
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.
Campbell
Ashley A
AA
Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
de Pee
Saskia
S
Sun
Kai
K
Kraemer
Klaus
K
Thorne-Lyman
Andrew
A
Moench-Pfanner
Regina
R
Sari
Mayang
M
Akhter
Nasima
N
Bloem
Martin W
MW
Semba
Richard D
RD
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