Measuring food insecurity among a national sample of children with recurrent acute otitis media
Thomas B Cwalina1, James R Xu1, Jessica Pham1
1Case Western Reserve University School of Medicine, Cleveland, OH, United States of America; University Hospitals Cleveland Medical Center, Department of Otolaryngology, Cleveland, OH, United States of America.
Insights
Food insecurity affects over 20% of children with recurrent acute otitis media (RAOM). Risk factors include older age, Black race, lower income, public insurance, and poor health, highlighting a need for clinical screening.
Area of Science:
- Pediatric Health
- Public Health
- Epidemiology
Background:
- Acute otitis media (AOM) is a common pediatric condition, with recurrent AOM (RAOM) posing a significant healthcare burden.
- Food insecurity and malnutrition are linked to increased infection risk and adverse health outcomes in children.
- Limited data exists on food insecurity risk factors specifically within the pediatric RAOM population.
Purpose of the Study:
- To estimate the prevalence of food insecurity among children with RAOM.
- To identify sociodemographic risk factors associated with food insecurity in this population.
Main Methods:
- Utilized National Health Interview Survey (NHIS) data from 2011-2018.
- Analyzed sociodemographic characteristics and food insecurity prevalence in pediatric RAOM patients.
- Employed multivariable logistic regression using R's "survey" package to identify risk factors.
Main Results:
- 20.8% of children with RAOM experienced food insecurity.
- Significant risk factors included older age (6-10, >10 years), Black race, lower federal poverty levels (<200%), public insurance or being uninsured, and poor to fair self-reported health status.
- These factors remained significant and independent of each other in multivariable analysis.
Conclusions:
- Children with RAOM who are older, Black, have less insurance, lower income, or poorer health are more likely to be food insecure.
- Integrating food insecurity screening and referral programs into clinical practice can help otolaryngologists address disparities and improve outcomes for at-risk children.
Introduction:
Acute otitis media is one of the most common reasons for pediatric medical visits in the United States. Additionally, past studies have linked food insecurity and malnutrition with increased infections and worse health outcomes. However, there is a lack of information on the risk factors for food insecurity in specific patient populations, including the pediatric recurrent acute otitis media (RAOM) population.
Methods:
The 2011 to 2018 National Health Interview Survey (NHIS) datasets were used to obtain a national estimate of the presentation of food insecurity within pediatric patients with RAOM. Relevant sociodemographic information and prevalence were identified. A multivariable logistic regression model was used to determine sociodemographic risk factors. Calculations were conducted using R with the "survey" package to account for the clustering and sampling of the NHIS.
Results:
Of 3844 children with RAOM who responded to the food insecurity module, 20.8 % (19.0-22.6 %) were food insecure. Age, race/ethnicity, percentage of federal poverty level status, insurance status, and self-reported health status were significant and were not independent of food insecurity status. Using multivariable regression, this study found the following sociodemographic risk factors: age 6-10 and age > 10 (reference: age 0-2); Black (reference: Non-Hispanic White); 100 % to 200 % and <100 % federal poverty level (reference: >200 % federal poverty level); public insurance or uninsured status (reference: private insurance); and poor to fair self-reported health status (reference: good to excellent).
Discussion:
Children with RAOM who were older, Black, less insured, living in lower-income households, and of poorer health had a greater association with being food insecure. Due to the frequency of RAOM pediatric visits, identifying at-risk groups as well as incorporating food insecurity screening and food referral programs within clinical practice can enable otolaryngologists to reduce disparities and improve outcomes in a targeted approach.
