Household Food Insecurity, Dietary Diversity, Stunting, and Anaemia among Left-Behind Children in Poor Rural Areas of China.

Yang Yang,Zhang Zhang,Zou Zou,Deng Deng,Ji Ji,Yuan Yuan,Lin Lin

doi:10.3390/ijerph16234778

Abstract

Left-behind children (LBC) are a newly emerged social group in China. Poor nutritional status is particularly prominent in this population. However, their food insecurity tends to attract very little attention. This study aims to investigate the relationship between food insecurity and undernutrition (stunting and anaemia) in 3 to 5-year-old LBC in rural China. Face-to-face interviews were administered to 553 LBC caregivers in 40 rural villages of Hunan Province, China. The Household Food Insecurity Access Scale (HFIAS) was used to assess household food insecurity (HFI). Dietary diversity score (DDS) and food group consumption frequency were measured by 24 h-recall and food frequency questionnaires (FFQ). Hemoglobin tests and anthropometric measurements including height and weight were measured by trained health professionals. Logistic regression was constructed to assess the association between household food insecurity and dietary diversity, stunting, and anaemia. A high prevalence of household food insecurity was determined (67.6%). The weighted prevalence of stunting and anaemia were 16.6% and 26.5%, respectively. Food insecurity was positively associate with LBC stunting (severe HFI: OR = 6.50, 95% CI: 2.81, 15.00; moderate HFI: OR = 3.47, 95% CI: 1.60, 7.54), and anaemia (severe HFI: OR = 1.91, 95% CI: 1.02, 3.57). LBC with food insecurity had significantly lower dietary diversity than those who were food-secure (p < 0.001). The prevalence of household food insecurity among LBC in poor rural China is high and is associated with low DDS, stunting, and anaemia. Nutritional intervention programs and policies are urgently needed to reduce household food insecurity and undernutrition for this vulnerable population.

Highlights

Child undernutrition is a major worldwide health concern, which often causes irreversible damage to the physical and mental health of children as well as adversely affecting health and productivity throughout adulthood
Most of the Left-behind children (LBC) observed were of Han ethnicity (61.8%) and had both parents working outside the home (74.7%)
We found that the prevalence of HFI was 67.6% among the observed LBC, while 15.4%, 33.4%, and 18.8% of them had mild, moderate, and severe household food insecurity, respectively

Summary

Introduction

Child undernutrition is a major worldwide health concern, which often causes irreversible damage to the physical and mental health of children as well as adversely affecting health and productivity throughout adulthood. Due to lower socio-economic status and inadequate health facilities, rural areas of China may be facing a severe challenge of child stunting and anaemia, especially for left-behind children (LBC). The number of LBC in China has increased dramatically from 15.8 to 23.4 million between 2005 and 2013 because of the continually increasing population of migrant workers [1,2] Public Health 2019, 16, 4778; doi:10.3390/ijerph16234778 www.mdpi.com/journal/ijerph

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