Prevalence of Food Insufficiency Across Subgroups of Children with Special Health-Care Needs

To determine the association between subgroups of children with special health care needs (SHCN) and food insufficiency, and assess whether this association varies by income level, and to evaluate how food insufficiency trends have changed over the time.

This was a cross-sectional survey study using the 2016-2023 National Surveys of Children's Health. SHCN subgroups were defined as follows: no special health care needs, prescription medication use only, elevated use of services, and functional limitations. The association between SHCN subgroup and food insufficiency was measured using weighted multivariable logistic regression models. Effect modification by income was evaluated. In addition, linear models described significant changes in food insufficiency rates by SHCN subgroup from 2016 to 2023.

Compared with children without SHCN, children with SHCN who used medications only (aOR = 1.31; 95% CI 1.21-1.41), had elevated use of services (aOR = 1.54; 95% CI 1.45-1.63), or had functional limitations (aOR 1.97; 95% CI 1.82-2.13) had higher odds of food insufficiency. Effect modification by income was significant for children with functional limitations. From 2016 to 2023, the associations between SHCN and food insufficiency were similar.

Children with functional limitations are an especially high-risk group who require attention in public health efforts to reduce food insufficiency.