Household Food Insecurity is Associated with Childhood Asthma.
BACKGROUND
In 2013, 20% of U.S. households with children experienced food insecurity. Asthma afflicts over 7 million children; prevalence has steadily increased while incidence peaks in young children. Asthma and food insecurity share the determinants of poverty and race that are associated with weight, yet limited research on the relation between food insecurity and asthma exists.


OBJECTIVE
The objective of this study was to determine the association between food insecurity and asthma in a diverse sample of children.


METHODS
Cross-sectional data from grade 3 of the Early Childhood Longitudinal Study-Kindergarten Cohort were analyzed (n = 11,099). Food security based on the USDA module and asthma diagnosis were reported by parents; anthropometric factors were measured. Multivariate logistic regression models of food security and asthma were analyzed overall and by race/ethnicity.


RESULTS
Children in food-insecure households had a 4% higher adjusted odds of asthma (95% CI: 1.02, 1.06). Adjusted odds of asthma were also higher by 70% for males (95% CI: 1.69, 1.71), 53% for non-Hispanic black (NHB) children (95% CI: 1.51, 1.54), 20% for Hispanic children (95% CI: 1.19, 1.21), 38% for overweight children (95% CI: 1.36, 1.39), 67% for obese children (95% CI: 1.65, 1.68), 23% for low-birth weight children (95% CI: 1.21, 1.24), 24% if mothers had a high school diploma (95% CI: 1.23, 1.26), and 33% if mothers had some college education (95% CI: 1.32, 1.35). High-birth weight children (OR: 0.84; 95% CI: 0.83, 0.85) and those with foreign-born mothers (OR: 0.52; 95% CI: 0.51, 0.53) had lower odds of asthma. Being food-insecure remained positively associated with asthma in non-Hispanic whites and Hispanics but was inversely associated with odds among NHBs. Odds of asthma doubled (OR: 2.00; 95% CI: 1.97, 2.03) for all children in households that were both food-insecure and poor; this relation remained positive in race/ethnicity-specific models.


CONCLUSIONS
Food insecurity is positively associated with asthma in U.S. third graders, and household poverty strengthens the association.
Department of Nutritional Sciences and mangini@mail.utexas.edu.
Lauren D
LD
Mangini
Department of Sociology and Population Research Center, The University of Texas at Austin, Austin, TX.
Mark D
MD
Hayward
Department of Nutritional Sciences and.
Yong Quan
YQ
Dong
Department of Nutritional Sciences and.
Michele R
MR
Forman
D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D001724:Birth Weight; D044383:Black People; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006630:Hispanic or Latino; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D016017:Odds Ratio; D050177:Overweight / Q000150:complications / Q000453:epidemiology; D011203:Poverty; D014481:United States / Q000453:epidemiology; D001741:Black or African American
BMI; Early Child Longitudinal Study–Kindergarten Cohort; USDA Household Food Security Survey Module; asthma; birth weight; food insecurity; race