Association and disparities of food insecurity and child abuse: Analysis of the National Survey of Children’s Health

Abstract

Background: Child abuse is a major public health issue and is a significant risk factor for compromised development, health morbidities, and the development of mental and behavioral disorders in children. Many factors contribute to child abuse, especially family stressors. Food insecurity, a significant family stressor, likely increases the rate of child abuse while also contributing directly and indirectly to the consequences on child development and lifespan. Given the adverse effects of child abuse and food insecurity, investigating their relationship is crucial to developing mitigation strategies.

Purpose: Our primary objective was to assess the relationship between child abuse and food insecurity using data from the National Survey of Children’s Health (NSCH). Given that these disproportionately affect children of different demographic groups, our study aims to identify associations amongst varying demographic factors.

Methods: We conducted an observational study assessing the National Survey of Children’s Health (2016-2021) to investigate the relationship between food security and child abuse. Using survey weights provided by the NSCH, we determined population estimates and rates of children experiencing food insecurity and child abuse. We then constructed logistic regression models to assess associations, via odds ratio, between food security groups and whether the child experienced child abuse. Finally, we constructed logistic regression models, via odds ratios, to assess food security and child abuse by demographic factors.

Results: While rates of food security were similar across age groups, households with lower income had higher rates of marginal or low food security, as well as homes with Black, Indigenous, multi-racial, and Hispanic children. Compared to those with high food security, the odds of children with marginal or low food security were significantly more likely to experience child abuse (AORs: 2.36, 95% CI: 2.17-2.57 and 5.24, 95% CI: 4.59-6.00, respectively). Compared to White children with high food security, Indigenous, Black, and White children were significantly more likely to experience child abuse as household food security decreased.

Conclusion: Child abuse and food insecurity have a significant association, including overlapping contributory factors and disparities. Efforts to improve food insecurity through policy, community food banks, and school-based programs may secondarily reduce child abuse. To address racial/ethnic disparities, the expansion of culturally-competent, evidence-based programs to reduce food insecurity should be established, which may also reduce risk factors for child abuse.