Weigel M Margaret, Armijos Rodrigo X
Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, USA.
Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, USA.
Int J Pediatr. 2018 Aug 13;2018:6067283. doi: 10.1155/2018/6067283. eCollection 2018.
Household food insecurity (HFI) is a major global public health and pediatric concern due to its reported association with adverse child nutrition, growth, and health outcomes. Psychosocial dysfunction is a major cause of childhood disability. US and Canadian studies have linked HFI to poorer overall psychosocial dysfunction and specific dysfunction types in school-aged children, i.e., internalizing, externalizing, and attention behaviors. However, it is uncertain whether prior findings are generalizable to low- and middle-income country (LMIC) settings. We conducted a cross-sectional study to explore the association of HFI with psychosocial dysfunction in 6-12-year-old public elementary schoolchildren (n=279) residing in low-income neighborhoods in Quito, Ecuador. Maternal caregivers were interviewed to obtain data on child psychosocial dysfunction (Pediatric Symptom Checklist, PSC), food security (Household Food Security Survey Module), and maternal mental health (SF-36 Mental Composite Summary). Capillary blood samples were obtained from child participants to measure hemoglobin levels. The data were analyzed using general linear models with adjustment for covariates. The results revealed that HFI was associated with significantly higher overall average PSC scores (p=0.002) and with internalizing (p=0.001) and externalizing (p=0.03) but not attention subscale scores. However, anemia was independently associated with PSC attention subscale scores (p=0.015). This is the first study to report on the relationship between HFI and psychosocial dysfunction in school-aged children in a LMIC setting. It highlights the importance of improving policies and programs protecting vulnerable households from HFI. In addition to improving health and nutrition, such improvements could potentially reduce the burden of child psychosocial dysfunction.
家庭粮食不安全（HFI）是一个重大的全球公共卫生和儿科问题，因为据报道它与儿童不良营养、生长和健康结果有关。心理社会功能障碍是儿童残疾的主要原因。美国和加拿大的研究已将家庭粮食不安全与学龄儿童更严重的总体心理社会功能障碍以及特定功能障碍类型联系起来，即内化、外化和注意力行为。然而，之前的研究结果是否适用于低收入和中等收入国家（LMIC）环境尚不确定。我们进行了一项横断面研究，以探讨家庭粮食不安全与居住在厄瓜多尔基多低收入社区的6至12岁公立小学儿童（n = 279）心理社会功能障碍之间的关联。对母亲照顾者进行访谈，以获取有关儿童心理社会功能障碍（儿科症状清单，PSC）、粮食安全（家庭粮食安全调查模块）和母亲心理健康（SF - 36心理综合摘要）的数据。从儿童参与者身上采集毛细血管血样以测量血红蛋白水平。使用一般线性模型对协变量进行调整后分析数据。结果显示，家庭粮食不安全与总体平均PSC得分显著更高（p = 0.002）以及内化（p = 0.001）和外化（p = 0.03）相关，但与注意力子量表得分无关。然而，贫血与PSC注意力子量表得分独立相关（p = 0.015）。这是第一项报告低收入和中等收入国家环境中学龄儿童家庭粮食不安全与心理社会功能障碍之间关系的研究。它强调了改善政策和计划以保护弱势家庭免受家庭粮食不安全影响的重要性。除了改善健康和营养外，并改善可能会减轻儿童心理社会功能障碍的负担。
