Household food insecurity and childhood obesity/overweight among children with special healthcare needs: Results from a nationally representative sample of 10-17 years old U.S. children.

Abstract

Food insecurity is linked to an increased risk of childhood obesity and other adverse health issues. To examine the disproportionate impact of food insecurity on childhood obesity among children with special healthcare needs (CSHCN). In this cross-sectional study, we pooled data from 4 years (2016 to 2019) of the National Survey of Children's Health (NSCH) for a nationally representative sample of 10 to 17 years old noninstitutionalized U.S. children (N=68 942). Using logistic regression models, we examined the odds of childhood obesity or overweight by including an interaction between family food situation and CSHCN status. Among 10-17 years old U.S. children, 31% (95% confidence interval [CI]: 30.1%-31.9%) had obesity or overweight, 24.1% had special healthcare needs, 27.2% were from families with food insecurity, and 6.4% were from families with food insufficiency. CSHCN were more likely to be impacted by obesity or overweight than non-CSHCN (Odds Ratio [OR]=1.29, 95% CI=1.18-1.141). Moreover, children living in food insecurity (OR=1.75, 95% CI=1.52-1.92) and food insufficiency (OR=2, 95% CI=1.67-2.4) were more likely than those living in food-secure families to be impacted by obesity or overweight. CSHCN living in food insecurity were significantly more likely to be impacted by obesity or overweight than non-CSHCN in similar households. It appears that food insecurity can put CSHCN at disproportionately greater risk of obesity or overweight than non-CSHCN. The findings underscore considering CSHCN status in conjunction with household food insecurity in designing and implementing medical interventions or public policies targeted at childhood obesity or overweight.