MacBain Elspeth, Eltorki Mohamed, Marjerrison Stacey, Pardhan Alim, Wahi Gita, Ngo Quang N
Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
McMaster Children's Hospital, Hamilton, ON, Canada.
Paediatr Child Health. 2023 Jun 6;28(4):229-234. doi: 10.1093/pch/pxac133. eCollection 2023 Jul.
Food insecurity (FI) is associated with a number of adverse child health outcomes and increased emergency department (ED) use. The COVID-19 pandemic exacerbated the financial hardship faced by many families. We sought to determine the prevalence of FI among children with ED visits, compare this to pre-pandemic rates, and describe associated risk factors.
From September to December 2021, families presenting to a Canadian paediatric ED were asked to complete a survey screening for FI along with health and demographic information. Results were compared to data collected in 2012. Multivariable logistic regression was used to measure associations with FI.
In 2021, 26% (n = 173/665) of families identified as food insecure compared to 22.7% in 2012 (n = 146/644) a difference of 3.3% (95% CI [-1.4%, 8.1%]). In multivariable analysis, greater number of children in the home (OR 1.19, 95% CI [1.01, 1.41]), financial strain from medical expenses (OR 5.31, 95% CI [3.45, 8.18]), and a lack of primary care access (OR 1.27, 95% CI [1.08, 1.51]) were independent predictors of FI. Less than half of families with FI reported use of food charity, most commonly food banks, while one-quarter received help from family or friends. Families experiencing FI expressed a preference for support through free or low-cost meals and financial assistance with medical expenses.
More than one in four families attending a paediatric ED screened positive for FI. Future research is needed to examine the effect of support interventions for families assessed in medical care facilities including financial support for those with chronic medical conditions.
粮食不安全（FI）与许多不良儿童健康结局以及急诊科（ED）就诊次数增加有关。2019冠状病毒病大流行加剧了许多家庭面临的经济困难。我们试图确定急诊科就诊儿童中粮食不安全的患病率，将其与大流行前的比率进行比较，并描述相关风险因素。
2021年9月至12月，要求前往加拿大儿科急诊科就诊的家庭完成一项针对粮食不安全以及健康和人口信息的调查筛查。将结果与2012年收集的数据进行比较。采用多变量逻辑回归来衡量与粮食不安全的关联。
2021年，26%（n = 173/665）的家庭被认定为粮食不安全，而2012年为22.7%（n = 146/644），相差3.3%（95%置信区间[-1.4%，8.1%]）。在多变量分析中，家中孩子数量较多（比值比1.19，95%置信区间[1.01，1.41]）、医疗费用造成的经济压力（比值比5.31，95%置信区间[3.45，8.18]）以及缺乏初级医疗服务（比值比1.27，95%置信区间[1.08，1.51]）是粮食不安全的独立预测因素。粮食不安全家庭中不到一半的家庭报告使用过食品慈善机构，最常见的是食品银行，而四分之一的家庭得到了家人或朋友的帮助。经历粮食不安全的家庭表示倾向于通过免费或低成本餐食以及医疗费用经济援助获得支持。
在儿科急诊科就诊的家庭中，超过四分之一的家庭粮食不安全筛查呈阳性。未来需要开展研究，以检验针对在医疗机构接受评估的家庭的支持干预措施的效果，包括对患有慢性疾病的家庭提供经济支持。
