Rose-Jacobs Ruth, Black Maureen M, Casey Patrick H, Cook John T, Cutts Diana B, Chilton Mariana, Heeren Timothy, Levenson Suzette M, Meyers Alan F, Frank Deborah A
Department of Pediatrics, Boston University School of Medicine, 91 East Concord St, Room 5106, Boston, MA 02118, USA.
Pediatrics. 2008 Jan;121(1):65-72. doi: 10.1542/peds.2006-3717.
In this study, we evaluated the relationship between household food security status and developmental risk in young children, after controlling for potential confounding variables.
The Children's Sentinel Nutritional Assessment Program interviewed (in English, Spanish, or Somali) 2010 caregivers from low-income households with children 4 to 36 months of age, at 5 pediatric clinic/emergency department sites (in Arkansas, Massachusetts, Maryland, Minnesota, and Pennsylvania). Interviews included demographic questions, the US Food Security Scale, and the Parents' Evaluations of Developmental Status. The target child from each household was weighed, and weight-for-age z score was calculated.
Overall, 21% of the children lived in food-insecure households and 14% were developmentally "at risk" in the Parents' Evaluations of Developmental Status assessment. In logistic analyses controlling for interview site, child variables (gender, age, low birth weight, weight-for-age z score, and history of previous hospitalizations), and caregiver variables (age, US birth, education, employment, and depressive symptoms), caregivers in food-insecure households were two thirds more likely than caregivers in food-secure households to report that their children were at developmental risk.
Controlling for established correlates of child development, 4- to 36-month-old children from low-income households with food insecurity are more likely than those from low-income households with food security to be at developmental risk. Public policies that ameliorate household food insecurity also may improve early child development and later school readiness.
在本研究中,我们在控制了潜在混杂变量后,评估了家庭粮食安全状况与幼儿发育风险之间的关系。
儿童哨兵营养评估项目在5个儿科诊所/急诊科地点(阿肯色州、马萨诸塞州、马里兰州、明尼苏达州和宾夕法尼亚州),对来自有4至36个月大孩子的低收入家庭的2010名照顾者进行了访谈(用英语、西班牙语或索马里语)。访谈内容包括人口统计学问题、美国粮食安全量表以及父母对发育状况的评估。对每个家庭的目标儿童进行称重,并计算年龄别体重z评分。
总体而言,在父母对发育状况评估中,21%的儿童生活在粮食不安全家庭,14%发育“有风险”。在对访谈地点、儿童变量(性别、年龄、低出生体重、年龄别体重z评分和既往住院史)以及照顾者变量(年龄、在美国出生、教育程度、就业情况和抑郁症状)进行控制的逻辑分析中,粮食不安全家庭的照顾者报告其孩子发育有风险的可能性比粮食安全家庭的照顾者高出三分之二。
在控制了已确定的儿童发育相关因素后,来自低收入且粮食不安全家庭的4至36个月大儿童比来自低收入且粮食安全家庭的儿童更有可能面临发育风险。改善家庭粮食不安全状况的公共政策也可能改善儿童早期发育及后期入学准备情况。