Savant Devina, Gjelsvik Annie, Yatchmink Yvette, High Pamela
Harvard Medical School, Harvard University, Boston, MA.
Massachusetts General Hospital for Children, Boston, MA.
J Dev Behav Pediatr. 2024;45(6):e552-e559. doi: 10.1097/DBP.0000000000001307. Epub 2024 Aug 13.
To investigate the relationship between food insecurity and developmental delay and/or behavior problems (DD/PB) in US children aged 2 to 5 years before the COVID-19 pandemic.
Data from 14,464 children aged 2 to 5 years from the National Survey of Children's Health from 2016 to 2017 were analyzed. Children with food insecurity came from families reporting they sometimes or often could not afford nutritious meals. Diagnosis of DD/PB by a professional was obtained through a caregiver report.
A quarter of children aged 2 to 5 years lived in food insecure homes, and 9% were diagnosed with DD/PB. Children in food insecure households were more likely to be from minoritized populations publicly insured, with single parents, without high school education, living =< 130% Federal poverty line, and receiving supplemental nutrition assistance program (SNAP) benefits (all p < 0.001). Adjusting for age, sex, race, ethnicity, poverty, family structure, and parent education, children in food insecure households had 1.57 times the odds of being diagnosed with DD/PB compared with children in food secure households. In similarly adjusted models excluding poverty and stratified by SNAP use, homes not receiving SNAP maintained this association between food insecurity and diagnosis of DD/PB, whereas in homes receiving SNAP, the association was not significant.
In this population-based study, US children aged 2 to 5 years in food insecure households were more likely to be diagnosed with DD/PB compared with those in food secure households. When stratified, there was no association between food insecurity and DD/PB among those receiving SNAP; the association remained for those not receiving SNAP. The potential long-term impact of this safety net program on our most vulnerable citizens must be considered as policymakers contemplate federal spending priorities.
调查2019冠状病毒病大流行之前美国2至5岁儿童的粮食不安全状况与发育迟缓及/或行为问题（DD/PB）之间的关系。
分析了2016年至2017年全国儿童健康调查中14464名2至5岁儿童的数据。粮食不安全儿童来自报告有时或经常无力负担营养膳食的家庭。通过照顾者报告获得专业人员对DD/PB的诊断。
四分之一的2至5岁儿童生活在粮食不安全家庭，9%被诊断为DD/PB。粮食不安全家庭中的儿童更有可能来自少数族裔、参加公共保险、单亲家庭、父母未接受高中教育、生活水平低于联邦贫困线130%以及领取补充营养援助计划（SNAP）福利的家庭（所有p<0.001）。在调整了年龄、性别、种族、民族、贫困、家庭结构和父母教育程度后，与粮食安全家庭中的儿童相比，粮食不安全家庭中的儿童被诊断为DD/PB的几率是其1.57倍。在排除贫困并按SNAP使用情况分层的类似调整模型中，未领取SNAP的家庭中，粮食不安全状况与DD/PB诊断之间的这种关联依然存在，而在领取SNAP的家庭中，这种关联并不显著。
在这项基于人群的研究中，与粮食安全家庭中的儿童相比，粮食不安全家庭中2至5岁的美国儿童更有可能被诊断为DD/PB。分层后，领取SNAP的人群中粮食不安全状况与DD/PB之间没有关联；未领取SNAP的人群中这种关联依然存在。在政策制定者考虑联邦支出优先事项时，必须考虑这一安全网计划对我们最脆弱公民的潜在长期影响。
