Abstract
The objectives of this cross-sectional study were to: (i) determine whether there are differences in self-esteem and self-efficacy for healthy lifestyle choices between children living in food secure and food insecure households; and (ii) determine whether the association between household food insecurity (HFI), self-esteem and self-efficacy differs by gender. Survey responses of 5281 fifth-grade students (10 and 11 years of age) participating in the Canadian Children’s Lifestyle and School Performance Study II were analyzed using logistic and linear regression. HFI status was determined by the six-item short-form Household Food Security Survey Module (HFSSM). Students from food insecure households had significantly higher odds of low self-esteem, and significantly lower scores for global self-efficacy to make healthy choices, compared to students from food secure households. These associations were stronger for girls than for boys and appeared independent of parental educational attainment. Household income appeared to be the essential underlying determinant of the associations of food insecurity with self-esteem and self-efficacy. Upstream social policies such as improving the household income of low-income residents will reduce food insecurity and potentially improve self-esteem and self-efficacy for healthy choices among children. This may improve health and learning, and in the long term, job opportunities and household earnings.
Highlights
In Canada and the United States, household food insecurity (HFI) as measured on national surveys refers to self-reports of uncertain or insufficient food access, due to limited financial resources.Recent national prevalence data of HFI in Canada and the United States were reported as 12% [1] and11.8% [2], respectively
Given we found self-esteem and self-efficacy were compromised among children from food insecure households, especially among girls, upstream policy actions targeting the structural determinants of HFI [45] should be prioritized
Population groups that require targeted support include girls, given the current study suggests they are more vulnerable to low self-esteem and self-efficacy if they are living in food insecure households [47,52]
Summary
In Canada and the United States, household food insecurity (HFI) as measured on national surveys refers to self-reports of uncertain or insufficient food access, due to limited financial resources.Recent national prevalence data of HFI in Canada and the United States were reported as 12% [1] and11.8% [2], respectively. Security Survey Module (HFSSM), to capture a gradient of deprivation within households This ranges from anxiety about running out of food, to impacts on diet quality and quantity [2,3], which can have cognitive and physical health consequences [4]. Such consequences resulting from HFI include multiple poor health outcomes, higher health care utilization and costs [5,6], higher mortality rates [7] and adverse mental health outcomes such as behavioural issues, distress, anxiety, depression and suicidal thoughts [6,8,9,10].
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