Social vulnerability and child food insecurity in developed countries: A systematic review.

Food insecurity (FI) is a serious public health concern in economically developed countries, mainly due to unequal resource distribution. Identifying social vulnerability factors (i.e., characteristics of a person or group regarding their capacity to anticipate, cope with, resist and recover from the effects of child food insecurity (CFI)) and their positive or negative relationship with CFI is important to support targeted action with a scale and intensity that is proportionate to the level of disadvantage. This review aimed to systematically and comprehensively identify key social vulnerability contributors to CFI in economically developed countries and discuss the factors in the context of the socio-ecological model (SEM). Five research databases were searched for observational studies published from 2000 assessing social vulnerability factors related to FI in children residing in developed countries. Data screening and extraction was independently conducted by two reviewers who recorded factors related to CFI. The QualSyst tool was used to assess risk of bias. From the studies identified (N=5,689), 49 papers, predominantly from the United States (U.S.) and Canada, met the inclusion criteria. The identified social vulnerability factors associated with CFI were grouped into five based on the SEM: i) individual child; ii) parental; iii) household; iv) community; and v) societal factors. The most frequently reported contributors to CFI were income (household factor). Other social vulnerability factors were identified, including child's age, parental depression, household crowdedness, social connection, poverty and residential instability. The lack of consistent measures to define both social vulnerability and CFI in diverse population subgroups impeded meaningful pooling and interpretation of factors interacting with CFI. Recommendations for future studies are to use comparable measures to estimate the extent and severity of CFI and to investigating the relation between social vulnerability, severity, and trajectories of CFI in developed countries. The review protocol was registered in PROSPERO (CRD42022291638).