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Abstract

Background: Given that an alarming 1 in 5 children in the USA are at risk of hunger (1 in 3 among black and Latino children), and that 3.9 million households with children are food insecure, it is crucial to understand how household food insecurity (HFI) affects the present and future well-being of our children.

Purpose: The objectives of this review article are to: (i) examine the association between HFI and child intellectual, behavioral and psycho-emotional development, controlling for socio-economic indicators; (ii) review the hypothesis that HFI is indeed a mediator of the relationship between poverty and poor child development outcomes; (iii) examine if the potential impact of HFI on caregivers’ mental health well-being mediates the relationship between HFI and child development outcomes.

Methods: Pubmed search using the key words “food insecurity children.” For articles to be included they had to: (i) be based on studies measuring HFI using an experience-based scale, (ii) be peer reviewed, and (iii) include child intellectual, behavioral and/or socio-emotional development outcomes. Studies were also selected based on backward and forward Pubmed searches, and from the authors’ files. After reviewing the abstracts based on inclusion criteria a total of 26 studies were selected.

Results: HFI represents not only a biological but also a psycho-emotional and developmental challenge to children exposed to it. Children exposed to HFI are more likely to internalize or externalize problems, as compared to children not exposed to HFI. This in turn is likely to translate into poor academic/cognitive performance and intellectual achievement later on in life. A pathway through which HFI may affect child development is possibly mediated by caregivers’ mental health status, especially parental stress and depression. Thus, HFI is likely to foster dysfunctional family environments.

Conclusion: Findings indicate that food insecure households may require continued food assistance and psycho-emotional support until they transition to a “stable” food secure situation. This approach will require a much better integration of social policies and access to programs offering food assistance and mental health services to those in need. Findings also fully justify increased access of vulnerable children to programs that promote early in life improved nutrition as well as early psycho-social and cognitive stimulation opportunities.

Key Take Away Points

  • Household food insecurity (HFI) is a powerful psycho-emotional family stressor.
  • HFI is associated with suboptimal child behavioral and intellectual development outcomes independent of poverty status.
  • The negative influence of HFI on parental mental health outcomes may mediate the relationship between HFI and suboptimal child development.
  • Food insecure households may require continued food assistance and psycho-emotional support until they transition to a “stable” food secure situation.
  • Vulnerable children need increased access to programs such as Head Start that promote early in life improved nutrition, as well as early psycho-social and cognitive stimulation opportunities.

Author Biography

Dr. Rafael Pérez-Escamilla is Professor of Epidemiology & Public Health and Director, Office of Community Health, Yale School of Public Health. His public health nutrition and food security research has led to improvements in breastfeeding promotion, iron deficiency anemia among infants (by delaying the clamping of the umbilical cord after birth), household food security measurement and outcomes, and community nutrition education programs worldwide. His health disparities research involves assessing the success of community health workers at improving behavioral, metabolic, and mental health outcomes among Latinos with type-2 diabetes. He has published 120 research articles and over 300 conference abstracts, book chapters, and technical reports.

Dr. Rodrigo Pinheiro de Toledo Vianna is Professor at the Department of Nutrition, Federal University of Paraiba, Brazil. His work focuses on household food insecurity measurement at the local level using experience-based scales, mental health among health care providers, and infant feeding patterns and determinants. He is currently a visiting professor at the Yale School of Public Health. He obtained his PhD in epidemiology from the University of Campinas.

Acknowledgements

Partially supported by the National Center on Minority Health and Health Disparities, National Institutes of Health EXPORT Grant P20 MD001765. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center on Minority Health and Health Disparities or the National Institutes of Health.