Adverse childhood experiences and household food insecurity among children aged 0-5 years in the USA.

Objective: Although studies have examined the association between adverse childhood experiences (ACE) and health and mental health outcomes, few studies have investigated the association between ACE and household food insecurity among children aged 0-5 years in the USA. The objective of this study is to investigate the association between ACE and household food insecurity among children aged 0-5 years.

Design: The data used in this study came from the 2016-2017 National Survey of Children's Health. Data were analysed using multinomial logistic regression with household food insecurity as the outcome variable.

Setting: United States.

Participants: An analytic sample of 17 543 children aged 0-5 years (51·4% boys).

Results: Of the 17 543 respondents, 83·7% experienced no childhood adversity. About one in twenty (4·8%) children experienced moderate-to-severe food insecurity. Controlling for other factors, children with one adverse childhood experience had 1·43 times the risk of mild food insecurity (95 % CI 1·25, 1·63) and 2·33 times the risk of moderate-to-severe food insecurity (95 % CI 1·84, 2·95). The risk of mild food insecurity among children with two or more ACE was 1·5 times higher (95 % CI 1·24, 1·81) and that of moderate-to-severe food insecurity was 3·96 times higher (95 % CI 3·01, 5·20), when compared with children with no childhood adversity.

Conclusion: Given the critical period of development during the first few years of life, preventing ACE and food insecurity and early intervention in cases of adversity exposure is crucial to mitigate their negative impact on child development.