Household food insecurity (FI) refers to a condition without reliable access to a
sufficient quantity of affordable, nutritious food, even for a temporary
FI occurs in 21% of families with children and adolescents
in the United States, but the potential developmental and behavioral
implications of this prevalent social determinant of health have not
been completely understood.
‘Household food insecurity (FI) is associated with children's behavioral, academic and emotional problems beginning as early as infancy.’
Household food insecurity (FI) is associated with children's behavioral, academic and
emotional problems beginning as early as infancy. These findings, based on a review of previously published research, appear in the Journal of Developmental & Behavioral Pediatrics
Researchers from Boston University School of Medicine (BUSM) and
Boston Medical Center (BMC) studied 23 peer-reviewed articles on the
associations between FI and adverse childhood developmental-behavioral
outcomes including early cognitive development, academic performance,
inattention, externalizing behaviors and depression in four
groups - infants and toddlers, preschoolers, school age and adolescent.
Among their findings:
- Articles that examined infants and toddlers suggest
that FI poses a developmental risk, impairs child attachment, mental
proficiency and cognitive assessment scores.
- In preschool years, studies have found an association between
FI, externalizing and internalizing behaviors and mental health
symptoms, and less optimal self-control and interpersonal skills.
- In school-aged children, an association was found between FI
and impaired academic performance, increased hyperactivity, inattention,
aggressive behavior, missing school, emotional problems, less adaptive
interpersonal relations, self-control and approaches to learning, more
internalizing and externalizing behaviors and greater likelihood of
having seen a psychologist.
- Finally, studies involving adolescents indicate associations
between FI and anxiety, depression and suicidal ideation, attempted
suicide, dysthymia, seeing a counselor, suspension from school,
difficulty getting along with others and substance use disorders.
According to the researchers physicians don't usually think of child
nutrition programs like WIC, school meals and SNAP (food stamps) as
prevention or intervention for the "new morbidity" - developmental and
behavioral/emotional problems which afflict a substantial proportion of
"Our findings suggest that these programs, which are
known to decrease food insecurity, may enhance the potential of our
children to learn, pay attention, and experience better emotional
health," explained corresponding author Deborah Frank, Professor in
Child Health and Well-Being, (Pediatrics) at BUSM and director of the
Grow Clinic for Children at BMC.
The researchers hope this systematic review will provide evidence of
the impact that temporary and even marginal food insecurity can have on
the development and behavior of children, such that it will inspire
greater awareness amongst healthcare providers, and ultimately, increase
This study was led by BUSM students Priya Shankar and Rain Jade Chung under the direction of Dr. Frank.