Hospitalization: Are We Missing an Opportunity to Identify Food Insecurity in Children?

Objective: Food security is the ability to access sufficient food to maintain a healthy, active life. Previous studies link food insecurity with adverse health outcomes. Our objectives were to determine the prevalence of food insecurity, identify sociodemographic risk factors, and quantify receipt of public nutrition assistance among recently hospitalized children in the United States.

Methods: Cross-sectional analyses of a representative sample of the US population aged 0 to 19 years from the National Health and Nutrition Examination Survey, 2007 to 2012 (N = 12,627). Consistent with previous literature, households were defined as food insecure if they answered "yes" to 3 or more of 18 food security questions. Children were considered recently hospitalized if admitted overnight in the past year (n = 706). Descriptive statistics characterized food insecurity and receipt of nutrition assistance. Multiple logistic regression analyses evaluated associations of food insecurity with age, sex, race/ethnicity, insurance status, family income, and hospitalization.

Results: One-quarter (25.3%) of recently hospitalized children lived in food insecure households. More than one-third of recently hospitalized low-income, uninsured, or Hispanic children lived in food insecure households. In the adjusted analysis, recently hospitalized low-income children and girls had significantly greater odds of living in food insecure households. Of potentially eligible hospitalized children, 26.9% had not received Women, Infants, and Children benefits and 31.0% had not received Supplemental Nutrition Assistance Program benefits in the past year.

Conclusions: One-quarter of recently hospitalized children lived in food insecure households. Many eligible families were not enrolled in public nutrition programs. Hospitalization represents a potential opportunity to identify these children and help families access nutrition assistance.