Food Insecurity, Childhood Obesity, and the Role of Assistance Programs

Abstract

Childhood obesity has become a major health issue in the United States and is disproportionately prevalent among low-income children. A relationship may exist between food insecurity—uncertain access to adequate food--and childhood obesity, but empirical findings have been inconclusive. This study uses National Health and Nutrition Examination Survey (NHANES) data from 2003-2012 (n = 7,430) to reassess the relationship between food insecurity and weight status among low-income (PIR ≤ 1.85) children and adolescents using objective body measures, multiple measures of food insecurity, the most recent available data, and analytic methods to differentiate between overweight and obesity. In addition, this study explores the impact of the three largest food assistance programs (WIC, SNAP, and the National School Lunch Program (NSLP)) on the relationship between food insecurity and child weight status. Results suggest that both household and child-referenced food insecurity are significantly and persistently associated with obesity, but not overweight, among low-income children. Household participation in WIC, SNAP, and the NSLP does not mediate the relationship between child food insecurity and weight status, but results suggest that NSLP participation may be associated with increased risk for obesity among low-income children. Although this study was unable to account for selection factors in assistance program participation, results suggest the need to adjust assistance measures to better meet the needs of low-income food-insecure families in order to improve the health of children both during childhood and over the life course.