184161 Housing instability impacts food security and well-being in young children

Tuesday, October 28, 2008: 11:30 AM

Diana B. Cutts, MD , Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN
Alan F. Meyers, MD, MPH , Department of Pediatrics, Boston Medical Center, Boston, MA
Mariana Chilton, PhD, MPH , Assistant Professor, Drexel University School of Public Health, Philadelphia, PA
Maureen Black, PhD , Department of Pediatrics, University of Maryland, School of Medicine, Baltimore, MD
Timothy Heeren, PhD , Youth Alcohol Prevention Center, Boston University School of Public Health, Boston, MA
John T. Cook, PhD , Department of Pediatrics, Boston University School of Medicine, Boston, MA
Patrick Casey, MD , Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR
Carol Berkowitz, MD , Dept of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA
Stephanie Ettinger de Cuba, MPH , Data Coordinating Center, Boston University School of Public Health, Boston, MA
Sharon M. Coleman, MS, MPH , Data Coordinating Center, Boston University School of Public Health, Boston, MA
Joni Geppert, MPH, RD, LN , Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN
Deborah A. Frank, MD , Department of Pediatrics, Boston Medical Center, Boston, MA
Background

Food security has been documented as a source of concern for child health and development. While homelessness has been well-studied in relationship to food security and child health, little is known about lesser degrees of housing instability.

Methods

From 8/98-6/07 the Children's Sentinel Nutrition Assessment Program (C-SNAP) interviewed 21,680 caregivers of children <3 years in pediatric clinic/emergency departments in 7 sites (AR,CA,MD,MA,MN,PA,DC). These sites all serve low-income, diverse populations. Interviews included demographics, perceived child health, maternal depression screen, the USDA Food Security Instrument, and the Parents' Evaluation of Developmental Status (PEDS). Logistic regression analyses were conducted controlling for site, race/ethnicity, US born mother, marital status, maternal education, child's age, child breastfed, low birth weight, number of children in home, employment, and maternal depression. Housing instability was defined as either crowding (> 2 people per bedroom) or multiple moves (lived 3 or more places/past year).

Results

Crowding was significantly associated with both HFI (AOR 1.25, 95 CI 1.14, 1.37; p=0.001) and CFI (AOR 1.22, 95 CI 1.08, 1.39; p=0.002) when compared with stable housing. Multiple moves was also significantly associated with HFI (AOR 2.05, 95 CI 1.72, 2.45; p=0.001) and CFI (AOR 2.17, 95 CI 1.74, 2.71; p=0.001) but was also significantly associated with significant developmental concerns (AOR 1.48, 95 CI 1.09, 2.01; p=0.01) and child's health perceived as fair/poor(AOR 1.51, 95 CI 1.23, 1.85; p=0.001).

Discussion

The impact of housing instability on household food insecurity (HFI), child food insecurity (CFI), developmental concerns and child health identifies the need for stable housing for families with young children as a key public health issue. Although both crowding and multiple moves impacted food security, the impact of multiple moves was associated with more serious risk to child well-being.

Learning Objectives:
Recognize the association between housing instability on both household and child food insecurity in families with children under three years of age. Describe the impact of housing instability on child development. Delineate differences between the impact of crowding and the impact of multiple moves on food insecurity and child well-being.

Keywords: Pediatrics, Food Security

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Involved in Food Security research since 1994
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Food Security: Stategies to Improve Its Impact on Diverse Populations
See more of: Food and Nutrition