Longitudinal Effects of Food Insecurity On Health Status Among School-Aged Children

Background and Purpose: This study examines the effects of food insecurity on child health by focusing on dynamic patterns of food insecurity across time. An emerging body of research has found that food insecure children are more likely to suffer from negative health outcomes than children in food secure household (Gunderson & Kreider, 2009; Cook et al., 2004; Alaimo et al., 2001). Despite of this detrimental health consequence of food insecurity, however, little is known about the importance of timing and duration of food insecurity with regards to health outcomes among school-aged children. In this study, we describe patterns of food insecurity over 9 years between kindergarten and 8th grade, using ECLS-K data and identify how patterns of food insecurity influence changes in children's health status.

Methods: Using four waves of data (kindergarten, 3rd, 5th, and 8th grade) from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), 6,450 children are selected for the analyses. We construct multiple categories to summarize food security status over the 4 waves (grades kindergarten, 3, 5, and 8), using the household food security measure from the USDA food security scale, , in order to capture both the timing and duration of food insecurity. Child health status measured by mothers' self-reports was categorized as excellent, very good, good, fair, or poor. A rich set of confounding factors, including economic resources, child characteristics, parental, household, and contextual characteristics, are controlled. A lagged dependent variable model using ordinary least squares (OLS) regression is utilized for the study.

Results: Results of descriptive analyses suggest that food insecurity over the multiple years is volatile, with occasional food insecurity much more common that persistent insecurity. Persistent food insecurity, as well as food insecurity at multiple but not all waves, appears strongly linked to negative changes in child health status, compared to persistent food security. Furthermore, less frequent periods of food insecurity appear to have smaller effects on children's health status changes as compared persistent food insecurity.

Conclusions and Implications: Our findings provide evidence that patterns of food insecurity over the kindergarten through eighth grade period are significantly associated with changes in health status among school-aged children, with more frequent periods of food insecurity associated with worse outcomes. The detrimental impact of persistent food insecurity on child health status adds to a growing body of evidence that food insecurity is a critical public health issue for children. Furthermore, our findings imply that policy interventions that alleviate persistent food insecurity may be effective means of improving child health.