Lambert Jennifer O, Perrin Eliana M, Sturner Raymond, Howard Barbara J, Johnson Sara B
Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Johns Hopkins University School of Nursing, Baltimore, MD.
J Dev Behav Pediatr. 2025 Jul 8. doi: 10.1097/DBP.0000000000001393.
To describe changes in household food security status among families with young children before and during the COVID-19 pandemic, when many families experienced changes in food security status because of pandemic disruptions and relief programs, and to investigate the association between household food insecurity (FI) before and/or during the pandemic and developmental milestone attainment.
We used an interrupted time series design to evaluate the association between household FI and developmental milestone attainment before and during the pandemic. Our sample included US children 0 to 5 years with FI and developmental screenings prepandemic (June 2017 to February 2020) and intrapandemic (May 2020 to May 2022) in the Comprehensive Health and Decision Information System. Children with no food insecurity were compared to children with only intrapandemic (new), only prepandemic (resolved), or both intrapandemic and prepandemic (persistent) FI.
We found lower developmental milestone attainment only in the persistent FI group, with significantly lower communication (adjusted difference = -0.17; 95% CI, -0.33 to -0.01) and personal-social (adjusted difference = -0.15; 95% CI, -0.30 to -0.01) scores, versus children with no FI. There were no differences in developmental milestone attainment in any domains for children with new or resolved FI compared to children with no FI.
Using the pandemic as a natural experiment to study how changes in household food security status are associated with development, we found that persistent, but not transient, household FI is associated with suboptimal early childhood development. To promote healthy development, pediatricians should promptly intervene to address FI and advocate for governmental programs that promote food security.
描述新冠疫情之前及期间有幼儿家庭的家庭粮食安全状况变化，当时许多家庭因疫情干扰和救助计划而经历了粮食安全状况的改变，并调查疫情之前和/或期间家庭粮食不安全（FI）与发育里程碑达成情况之间的关联。
我们采用中断时间序列设计来评估疫情之前及期间家庭粮食不安全与发育里程碑达成情况之间的关联。我们的样本包括综合健康与决策信息系统中在疫情前（2017年6月至2020年2月）和疫情期间（2020年5月至2022年5月）有粮食不安全状况且接受发育筛查的0至5岁美国儿童。将没有粮食不安全状况的儿童与仅在疫情期间有（新增）、仅在疫情前有（已解决）或在疫情期间和疫情前都有（持续存在）粮食不安全状况的儿童进行比较。
我们发现只有在持续存在粮食不安全状况的组中，发育里程碑达成情况较低，与没有粮食不安全状况的儿童相比，沟通（调整差异=-0.17；95%可信区间，-0.33至-0.01）和个人社交（调整差异=-0.15；95%可信区间，-0.30至-0.01）得分显著更低。与没有粮食不安全状况的儿童相比，新增或已解决粮食不安全状况的儿童在任何领域的发育里程碑达成情况均无差异。
以疫情作为一项自然实验来研究家庭粮食安全状况变化如何与发育相关联，我们发现持续存在而非短暂的家庭粮食不安全与幼儿发育欠佳有关。为促进健康发育，儿科医生应及时干预以解决粮食不安全问题，并倡导实施促进粮食安全的政府项目。
