Child hunger and long-term adverse consequences for health.

OBJECTIVE

To examine the effects of hunger, an extreme manifestation of food insecurity, on subsequent health outcomes using data from the Canadian National Longitudinal Survey of Children and Youth (NLSCY).

DESIGN

Longitudinal survey, 1994-2004/2005.

SETTING

Canada.

PARTICIPANTS

A total of 5809 children aged 10 to 15 years and 3333 youth aged 16 to 21 years.

MAIN EXPOSURES

Longitudinal survey data spanning a 10-year period were analyzed using logistic regression. Measures of hunger from NLSCY cycles 1 through 5 were used to differentiate participants who were ever hungry from those who were never hungry. A 3-level variable was created to assess the effect of repeated episodes of hunger. Covariates included participants' age, sex, baseline health, and household sociodemographic characteristics. Stratified models were used to examine the relation between hunger and health among boys and girls separately.

OUTCOME MEASURES

The NLCSY cycle 6 outcomes included poor general health, chronic health conditions, and asthma.

RESULTS

Among children, both ever being hungry and multiple episodes of hunger were associated with poorer general health but not with chronic conditions or asthma. Higher odds of chronic conditions and of asthma were observed among youth who experienced multiple episodes of hunger compared with those who were never hungry. Associations between hunger and poorer health outcomes persisted among girls in stratified analyses.

CONCLUSIONS

Children and youth who experience hunger are more likely to have poorer health, and repeated exposure appears to be particularly toxic. Our findings point to the relevance of food insecurity in childhood as a marker of vulnerability, with implications for clinical practice and advocacy.