title: Are food insecurity's health impacts underestimated in the U.S. population? Marginal food security also predicts adverse health outcomes in young U.S. children and mothers.
abstract: This review addresses epidemiological, public health, and social policy implications of categorizing young children and their adult female caregivers in the United States as food secure when they live in households with "marginal food security," as indicated by the U.S. Household Food Security Survey Module. Existing literature shows that households in the US with marginal food security are more like food-insecure households than food-secure households. Similarities include socio-demographic characteristics, psychosocial profiles, and patterns of disease and health risk. Building on existing knowledge, we present new research on associations of marginal food security with health and developmental risks in young children (<48 mo) and health in their female caregivers. Marginal food security is positively associated with adverse health outcomes compared with food security, but the strength of the associations is weaker than that for food insecurity as usually defined in the US. Nonoverlapping CIs, when comparing odds of marginally food-secure children's fair/poor health and developmental risk and caregivers' depressive symptoms and fair/poor health with those in food-secure and -insecure families, indicate associations of marginal food security significantly and distinctly intermediate between those of food security and food insecurity. Evidence from reviewed research and the new research presented indicates that households with marginal food security should not be classified as food secure, as is the current practice, but should be reported in a separate discrete category. These findings highlight the potential underestimation of the prevalence of adverse health outcomes associated with exposure to lack of enough food for an active, healthy life in the US and indicate an even greater need for preventive action and policies to limit and reduce exposure among children and mothers.
authors: Department of Pediatrics, Boston University School of Medicine, MA, USA. john.cook@bmc.org
authors: John T
authors: JT
authors: Cook
authors: Maureen
authors: M
authors: Black
authors: Mariana
authors: M
authors: Chilton
authors: Diana
authors: D
authors: Cutts
authors: Stephanie
authors: S
authors: Ettinger de Cuba
authors: Timothy C
authors: TC
authors: Heeren
authors: Ruth
authors: R
authors: Rose-Jacobs
authors: Megan
authors: M
authors: Sandel
authors: Patrick H
authors: PH
authors: Casey
authors: Sharon
authors: S
authors: Coleman
authors: Ingrid
authors: I
authors: Weiss
authors: Deborah A
authors: DA
authors: Frank
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D063105:Food Assistance; D005523:Food Supply / Q000191:economics*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D009035:Mothers; D015999:Multivariate Analysis; D009752:Nutritional Status; D011203:Poverty / Q000191:economics; D011634:Public Health; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult