Linking Food Insecurity and Coping Strategies to Children's Dietary Intake in Urban Areas in Surabaya, Indonesia

Background: Food insecurity continues to pose a significant public health challenge in urban low-income communities, where limited resources and unstable food systems may negatively relate to children's nutrition. Although prior studies have linked food insecurity with inadequate dietary intake, the role of coping strategies in this relationship remains insufficiently understood. This study investigated the associations between household food insecurity, coping strategies, and children's dietary intake in densely populated urban areas of Surabaya, Indonesia. Methods: A cross-sectional study was conducted among 55 mother-child pairs in Simolawang and Bulak Banteng from September 2025 to February 2026. We used the Household Food Insecurity Access Scale (HFIAS) and the Short Food Literacy Questionnaire (SFLQ), and coping behaviors were assessed using the Reduced Coping Strategy Index (r-CSI). Children's dietary intake was obtained through a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Pearson correlation and multivariate regression analyses were applied to examine relationships among variables. Results: Most households were classified as food secure (61.82%), although varying degrees of food insecurity were observed. Household food insecurity was not significantly associated with children's energy or macronutrient intake. In contrast, coping strategy scores were positively associated with household food insecurity (β = 0.26-0.27), indicating greater use of coping strategies among households experiencing greater food insecurity. Conclusions: Food insecurity was linked to increased coping behaviors but not directly to children's macronutrient intake. Coping mechanisms may help sustain short-term intake but do not guarantee adequate nutrition. Interventions should address both food access and dietary quality in urban poor settings.