Food Insecurity Before and During the COVID-19 Pandemic and Early Childhood Development

To describe changes in household food security status among families with young children before and during the COVID-19 pandemic, when many families experienced changes in food security status because of pandemic disruptions and relief programs, and to investigate the association between household food insecurity (FI) before and/or during the pandemic and developmental milestone attainment.

We used an interrupted time series design to evaluate the association between household FI and developmental milestone attainment before and during the pandemic. Our sample included US children 0 to 5 years with FI and developmental screenings prepandemic (June 2017 to February 2020) and intrapandemic (May 2020 to May 2022) in the Comprehensive Health and Decision Information System. Children with no food insecurity were compared to children with only intrapandemic (new), only prepandemic (resolved), or both intrapandemic and prepandemic (persistent) FI.

We found lower developmental milestone attainment only in the persistent FI group, with significantly lower communication (adjusted difference = -0.17; 95% CI, -0.33 to -0.01) and personal-social (adjusted difference = -0.15; 95% CI, -0.30 to -0.01) scores, versus children with no FI. There were no differences in developmental milestone attainment in any domains for children with new or resolved FI compared to children with no FI.

Using the pandemic as a natural experiment to study how changes in household food security status are associated with development, we found that persistent, but not transient, household FI is associated with suboptimal early childhood development. To promote healthy development, pediatricians should promptly intervene to address FI and advocate for governmental programs that promote food security.