Relationship Between Food Insecurity and Neighborhood Child Opportunity Index
Brandon J Ho1, Alexandra Rucker2, Meleah D Boyle1
1Department of Pediatrics, Children's National Hospital, Washington, DC.
Insights
Children in low-opportunity neighborhoods face higher food insecurity risks. This study links neighborhood conditions to food access, informing targeted interventions for vulnerable populations.
Area of Science:
- Public Health
- Social Epidemiology
- Pediatric Health
Background:
- Food insecurity is a critical public health issue affecting child well-being.
- Neighborhood characteristics, such as opportunity levels, may influence food security status.
- Understanding these associations is vital for developing effective interventions.
Purpose of the Study:
- To investigate the association between neighborhood opportunity, as measured by the Child Opportunity Index (COI), and food insecurity among children and adolescents.
- To identify potential disparities in food security based on residential neighborhood characteristics.
Main Methods:
- Secondary analysis of data from a social determinants of health screening in urban pediatric emergency departments.
- Inclusion of adolescents (13-21 years) and caregivers of children (0-17 years).
- Assessment of food insecurity using the 2-item Hunger Vital Sign and linkage with COI data using geocoded residential addresses. Statistical analysis involved bivariable and multivariable logistic regression.
Main Results:
- 15.7% of participants reported food insecurity.
- Participants residing in low/very low child opportunity neighborhoods had significantly higher odds (aOR, 3.0) of food insecurity compared to those in high opportunity neighborhoods.
- Non-Hispanic Black participants and those publicly insured were disproportionately represented among food-insecure individuals.
Conclusions:
- Lower neighborhood opportunity is significantly associated with increased food insecurity.
- Findings highlight the importance of place-based factors in understanding and addressing food insecurity.
- Results can guide the development of targeted screening and place-based interventions in pediatric settings.
Objectives:
To evaluate the association between the Child Opportunity Index (COI) and food insecurity.
Study Design:
This was a secondary analysis of a comprehensive screening instrument for social determinants of health and behavioral health risks. It was administered in 2 urban pediatric emergency departments to adolescents aged 13-21 years and caregivers of children aged 0-17 years. Food insecurity was assessed using the 2-item Hunger Vital Sign. Residential addresses were geocoded and linked with COI data. Bivariable and multivariable logistic regression models were developed to measure the relationship between COI and food insecurity.
Results:
Of the 954 participants (384 adolescents, 570 caregivers) who underwent screening, 15.7% identified food insecurity (14.3% of adolescent and 16.7% of caregiver participants). The majority of participants were non-Hispanic Black (overall, 62.3%; food secure, 60.9%; food insecure, 72.0%), were publicly insured (overall, 56.6%; food secure, 53.1%; food insecure, 73.3%), and lived in neighborhoods of low/very low opportunity (overall, 76.9%; food secure, 74.7%; food insecure, 88.3%). In adjusted analyses, participants living in neighborhoods of low/very low child opportunity had 3-fold greater odds of being food insecure compared with children living in neighborhoods of high child opportunity (aOR, 3.0; 95% CI, 1.4-6.3).
Conclusion:
We demonstrate that food insecurity is associated with lower neighborhood opportunity. Our results could inform future screening initiatives and support the development of novel, place-based interventions to tackle the complex issue of food insecurity.
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