Chronic health conditions and food insecurity in kids

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A recent Michigan Medicine-led study finds a link between chronic illness and higher food insecurity rates for children, even after accounting for income and other factors. Visit Health Lab for the full article.

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Today: Do children with chronic health conditions face a higher risk of food insecurity? A new Michigan Medicine-led study finds a link between chronic illness and higher food insecurity rates, even after accounting for income and other factors.

Food insecurity is more common among children with a chronic medical condition than those without one, the study suggests, and the prevalence of food insecurity remained higher in this group even after adjusting for key family and household characteristics, including income, education and employment status. The study was published recently in JAMA Network Open.

Dr. Nina Hill, a postdoctoral research fellow in the Susan B. Meister Child Health Evaluation and Research Center and National Clinician Scholars Program at the University of Michigan, says, “Our study suggests that children with chronic conditions should be prioritized in efforts to reduce the harms of food insecurity.”

Dr. Hill and colleagues analyzed nationally representative survey data from 2019 to 2023, which included 34,188 children in the United States between the ages of 2–17.

The analysis compared food insecurity rates among children with and without seven chronic conditions including asthma, attention deficit hyperactivity disorder or ADHD, autism spectrum disorder, developmental delay, intellectual disability, learning disability and prediabetes or diabetes.

The study also identified a stepwise increase in food insecurity risk, showing that the more chronic conditions a child had, the higher the likelihood their household experienced food insecurity.

The authors also analyzed trends in food insecurity over time and found that food insecurity rates improved for both children with and without chronic conditions around 2021, but that Pandemic-era gains were short lived.

This is likely in response to COVID-19 pandemic related policies like the expanded child tax credit and increased Supplemental Nutrition Assistance Program, also known as SNAP, and Special Supplemental Nutrition Assistance Program for Women Infants and Children, or WIC, benefits.

However, the data showed that when these policies expired, the progress that had been made in reducing food insecurity for children in the study were subsequently lost in 2022 and 2023.

While the study establishes an association between chronic conditions and food insecurity among children, it raises questions about the direction of this relationship.

The authors of the study say that more research is needed to understand whether food insecurity contributes to the development or worsening of chronic conditions.

Alternatively, it is possible that families of children with chronic conditions experience economic instability due to missed work and increased caregiving responsibilities, ultimately resulting in food insecurity.

The study also found that food insecurity is common in households with children. In the study, food insecurity affected approximately 10.2% of U.S. households with children ages 2-17.

The health consequences of food insecurity for children include increased risks for asthma, anemia, developmental delays, and poor mental health.

The study’s authors say the findings highlight the need to screen for food insecurity in pediatric care, especially among children with chronic conditions, and to connect families to available resources.

They point to programs like SNAP and WIC that may reduce food insecurity and mitigate its adverse health effects.

Health systems and health insurers are also increasingly implementing programs to assist food insecure patients through prescriptions for produce and medically tailored groceries and meals.

Several state Medicaid programs have piloted programs to address health related social needs as well, the most common of which is food insecurity.

Dr. Hill says, “Our findings highlight how critical it is to protect and strengthen national policies to address food insecurity in children. Now more than ever, our patients need access to effective nutrition support programs.”

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