The Impact of Assets on Young Child Nutrition: The Pathway Via Household Food Security and Child Dietary Intake

Background and Purpose: Over 200 million children are undernourished in the world according to the most updated statistics. Undernutrition, especially chronic undernutrition, can seriously impede both mental and physical development, which further results in adulthood poverty. 45% of child deaths, about 3.1 million annually, is caused by undernutrition. Among all the immediate causes of undernutrition, inadequate dietary intake is one of the most prominent which household food security underlies. Empirical studies report that assets, as the stock of wealth, could provide necessary support for child development and increase parents’ aspiration. By Structural Equation Modeling, this study examines 1) whether assets have positive effects on child nutritional outcome; 2) the mediating effects of household food security and child dietary intake.   

Methods: The study used the two most recent wave (Wave 2006 and 2009) of China Health and Nutrition Survey (n=688). China Health and Nutrition Survey is an on-going longitudinal data project using a multistage, random cluster sampling strategy. Assets was measured by wealth index, which is calculated based on dichotomous information of durable asset ownership by principle component analysis. Total amount of food available per day, amount of animal-source food available per day, and the number of food group available per day are proposed to measure household food security. The intake of total cariole, carbohydrate, protein, and fat per day are used to measure child dietary intake. According to WHO Growth Standards 2006, nutritional status was evaluated by anthropometric measures of height-for-age Z score (HAZ) indicating chronic undernutrition, weight-for-age Z score (WAZ), and weight-for-height Z scores (WHZ) indicating acute undernutrition. Control variables included child age and sex, education level and employment status of parents, household income, household size, whether the child was from urban or rural site, area, and wave. Structural Equation Modeling was used to analysis the data. A stepwise strategy was adopted to first test the measurement model and then build up the full SEM models. Root mean square error of approximation was selected as the main model-fit indicator.

Results: The model fitted the data well only when household food security was measured by the amount of animal-source food (ASF) and food vary score per day meanwhile child dietary intake was measured by protein and fat intake, where the indicators are proxies of food quality. Significantly positive association was found between assets and HAZ, but not WAZ and WHZ. Clear positive mediating effects of household food security and child dietary intake were reported. The education level of mothers was positively associated with child dietary intake as well. Area disparity was found in household food security, given that the households from coastal area are better than the households from middle and western area.

Conclusions and Implications: The findings show that assets could significantly promote food quality of household food security and child dietary intake, which can increase the intake of micronutrients and further relieve chronic undernutrition. Asset-based program together with mother education can be a promising intervention on chronic undernutrition of young children.