Increased Food Insecurity Among Mothers of 2 Year Olds with Special Health Care Needs
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The objective of this study is to explore the association between having a child with special health care needs (CSHCN) and food insecurity when the child is 2 years old. We studied women who had a live birth in 2004–2005 and responded to Oregon’s Pregnancy Risk Assessment Monitoring System (PRAMS) survey 3 months postpartum (Time 1) and the follow-up survey (PRAMS-2), when the child was 2 years old (Time 2). Women answering affirmatively to the PRAMS-2 question, “In the last 12 months, did you ever eat less than you felt you should because there was not enough money for food?” were considered food insecure. CSHCN status was identified by affirmative responses to questions about needs for ongoing services (Time 2). PRAMS and PRAMS-2 responses were weighted for study design and non-response. Results report weighted analyses, unless noted. Among 1812 mothers completing PRAMS-2, 13.6 % (unweighted) had a 2-year-old CSHCN and 11.9 % (unweighted) were food insecure at Time 2. The estimated prevalence of food insecurity at 2-year follow-up was 20.7 % among families of CSHCN and 9.7 % for others. After adjustment for Time 2 marital status, education, lifetime U.S. residence, income and health conditions, multivariable logistic regression revealed that odds of food insecurity were more than two times as great for CSHCN mothers 2 years post-partum compared to non-CSHCN mothers (adjusted odds ratio 2.6, 95 % confidence interval 1.3, 4.6). Families of CSHCN face increased risk for food insecurity. Improved understanding of causal determinants of food insecurity among households of CSHCN is needed.
KeywordsFood security Children with special health care needs (CSHCN) Social determinants of health PRAMS Oregon
We would like to acknowledge PRAMS and PRAMS-2 participants as well as Al Sandoval for providing technical assistance related to use of PRAMS and PRAMS-2 data and Tina Kent and Caitlyn Howell for their work in data collection. This work would not have been possible without their contributions. Funding for the PRAMS and PRAMS-2 surveys comes from the Oregon Health Authority; Oregon Office of Children and Youth with Special Health Needs (at Oregon Health & Science University); the Centers for Disease Control and Prevention (US Department of Health and Human Services (HHS)); and the Maternal and Child Health Bureau (Health Resources and Services Administration, HHS).
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