Hunger and Health: A Scoping Review Exploring Health Outcomes Associated with Food Insecurity for Youth (0-19 years)

Background & Purpose: There are more than 11 million children experiencing food insecurity (FI) in the United States. FI exists when households lack access, at times, to sufficient food due to limited money or resources. Though previous research has explored the association between FI and mental health symptoms, a synthesis on what is known about adverse physical health outcomes of FI among youth has not been done. This scoping review advances two questions: 1) What key health outcomes are associated with FI among youth aged 0-19 living in the U.S.?2) What is the state of the literature on FI and health outcomes among racial and ethnic minority youth?

Methods: Using the Peters and colleagues (2015) framework for quantitative data collection and analysis, this scoping review focused on published literature of the health outcomes for youth aged 0-19 who experience FI. A priori inclusion criteria included US based studies from 1/1/2010 -2/1/2021, measurement of FI, and an associated physical health outcome. Studies were excluded if it did not provide separate results for youth. Bibliographic databases used in this review included: PubMed, PsycInfo via EBSCO host, Embase, and Scopus; references were managed in Zotero. We used Covidence to screen titles, abstract and full-texts and to create data extraction forms.

Results: Two independent reviewers completed title and abstract screening of 2930 studies. Eighty-three studies were included for full text review and 29 studies were extracted. Of the included studies, 83% found a positive association between FI and an indicated health outcome. Sixteen different health outcomes were found to be positively associated with FI for youth aged 0-19 years old. The most commonly studied health outcomes associated with FI were elevated body mass index, poor general health, development of asthma, increased dental caries, risk for anemia, and high cholesterol. Twenty percent (n = 6) of included studies did not report the racial demographics of their population and 50% (n = 14) had a majority white sample.

Conclusions and Implications: Eliminating FI is an urgent need given its association with a wide range of adverse physical health outcomes for youth. As FI rates continue to rise due to the economic impact of the COVID-19, it is important to identify and understand whether and how FI affects youths’ physical wellbeing. Articles included in this study highlight the need for further exploration of the impact FI has on racial and ethnic minority youth. Nationally, racial and ethnic minority youth experience higher rates of FI but research on racial and ethnic minority youth is underdeveloped. Social workers (SW) must pay attention to FI and work to eradicate it. At the policy level, SWs can advocate for increase in food benefits and additional funds to support local food banks and food and nutritional programs. School based SWs can work with administration to ensure youth have access to meals during the school year and in the summer. Lastly, clinical SWs can work with pediatricians to ensure FI is screened for and addressed in well-child check-ups.