Food Insecurity Is Associated with Body Dissatisfaction among Children in California

BackgroundFood insecurity affects 13 million children in the United States. Body dissatisfaction is also prevalent, affecting up to 46% of children. Both food insecurity and body dissatisfaction are associated with poor health outcomes, and both are associated with body weight and racial/ethnic disparities. The association between food insecurity and body dissatisfaction among children has not been examined.ObjectiveThe purpose of this study was twofold: to examine, in a sample of children in grades 4 through 8, the relationship of child food insecurity with body dissatisfaction and to gain an understanding of the interactive roles of body mass index (BMI), race/ethnicity, and sex in the relationship between food insecurity and body dissatisfaction.DesignThis was a cross-sectional study.Participants/settingThis study examined data obtained from 14,768 children in grades 4 through 8 from 54 public schools in California between 2014 and 2016.Main outcome measuresThe primary outcome of interest was body dissatisfaction (five items converted to a binary indicator), and the exposure of interest was child-reported food insecurity (three items converted to a binary indicator). Subsets of validated questionnaires were used to assess body dissatisfaction and food insecurity.Statistical analyses performedData were analyzed using multivariable logistic regression, and effect modification was examined by BMI category (underweight, normal, overweight, obese), race/ethnicity, and sex.ResultsIn this large and diverse sample, after adjusting for cofounders, children experiencing food insecurity, in all BMI categories and from all racial/ethnic backgrounds, had higher odds of body dissatisfaction than their food-secure counterparts. The strength of the relationship differed by BMI and race/ethnicity, with the strongest associations observed for African-American children (odds ratio=2.32; P<0.001) and children with a normal children (odds ratio=1.76; P<0.001).ConclusionsExperiencing food insecurity was associated with greater body dissatisfaction, with the magnitude of the association modified by BMI and race/ethnicity.     

Household Food Insecurity Is Associated with Nutritional Status among Iranian Children

This cross-sectional study was conducted to determine household food security status and sociodemographic factors influencing it and to examine whether food insecurity of household is a risk factor for underweight, stunting, and thinness in primary school children of Sistan and Baluchestan Province in southeastern Iran. A sample of 610 students aged 7–11 years was selected by a multistage cluster random sampling method during December 2013–May 2014. Using U.S. Department of Agriculture Food Security questionnaire, 42.3% of households showed some degree of food insecurity. Food insecurity was positively associated with household size (p = .002) and number of children per household (p = .001) and negatively associated with mother’s and father’s education level (p = .005 and p = .042, respectively), father’s occupation status, and household income (p < .0001). Children living in food insecure with severe hunger households were 10.13, 10.07, and 4.54 times as likely to be underweight, stunted, and thin, respectively, as counterparts from food secure households. The findings showed food insecurity was prevalent and associated with sociodemographic factors among households with schoolchildren in southeastern Iran. Nutritional status of children was also associated with food security status of their households.     

The Relationship Between Food Insecurity and BMI for Preschool Children

Maternal and Child Health Journal - Objectives The literature exploring the relationship between food insecurity and obesity for preschool-aged children is inconclusive and suffers from...     

Food Insecurity Increases the Odds of Obesity Among Young Hispanic Children

Obesity is a growing public health concern and is more prevalent among low-income and minority populations. Food insecurity may increase the odds of obesity in children. We investigated the association between food insecurity and obesity among low-income, Hispanic, mother–child dyads (n = 74). The United States Department of Agriculture 18-item Household Food Security Survey was used to determine food security status. The majority of households were food insecure (74 %) and one-third (30 %) of children were obese. Food insecurity increased the odds of childhood obesity (OR 10.2; 95 % CI 1.2, 85.5) with stronger associations found within households where mothers were also overweight/obese compared to normal weight (p-for interaction < 0.05). Rates of household food insecurity and childhood obesity were high among this low-income Hispanic sample. Future studies should elucidate the mechanisms through which food insecurity impacts childhood obesity.     

A Longitudinal Study of Food Insecurity on Obesity in Preschool Children

BackgroundObesity and its co-occurrence with household food insecurity among low-income families is a public health concern, particularly because both are associated with later adverse health consequences.ObjectiveOur aim was to examine the relationship between household food insecurity with and without hunger in infancy and later childhood with weight status at 2 to 5 years.DesignThis longitudinal study uses household food-security status, weight, and height data collected at the first infancy and last child (2 to 5 years) Special Supplemental Nutrition Program for Women, Infants, and Children visits. Household food security was based on parent/caretaker responses to a four-question subscale of the 18-item Core Food Security Module. Obesity was defined as sex-specific body mass index for age ≥95th percentile.Participants/settingA diverse (58.6% non-white) low-income sample of 28,353 children participating in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (2001-2006); 24.9% of infants and 23.1% of children lived in food-insecure households and 17.1% were obese at their last child visit.Statistical analysisMultivariate logistic regression analyses assessed the association between household food-security status during the infant and child visits, and risk of preschool obesity, while controlling for child race/Hispanic ethnicity, sex, child and household size, maternal age, education, and prepregnancy weight. Interactions between these covariates and household food-security status were also examined. In cases of multiple comparisons, a Bonferroni correction was applied.ResultsPersistent household food insecurity without hunger was associated with 22% greater odds of child obesity (odds ratio=1.22; 95% CI 1.06 to 1.41) compared with those persistently food secure (P<0.05). Maternal prepregnancy weight status modified this association with children of underweight (adjusted odds ratio=3.22; 95% CI 1.70 to 6.11; P=0.003) or overweight/obese (adjusted odds ratio=1.34; 95% CI 1.11 to 1.62; P=0.03) mothers experiencing greater odds of child obesity with persistent household food insecurity without hunger compared with those with persistent household food security.ConclusionsThese results suggest that persistent household food insecurity without hunger is prospectively related to child obesity, but that these associations depend on maternal weight status. Vulnerable groups should be targeted for early interventions to prevent overweight and obesity later in life.     

High Prevalence of Food Insecurity and Hunger in Households in the Rural Lower Mississippi Delta

CONTEXT: Residents of the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi are at risk for food insecurity since a high proportion of the population live in households with incomes below the poverty level and have reduced access to food and decreased availability of a variety of foods. However, the magnitude of the problem is unknown because presently only nationwide and state estimates of food insecurity are available. PURPOSE: This study was conducted by the Lower-Mississippi Delta Nutrition Intervention Research Consortium to determine the prevalence of household food insecurity, identify high-risk subgroups in the Lower Delta, and compare to national data. METHODS: A 2-stage stratified cluster sample representative of the population in 36 counties in the Lower Delta was selected using list-assisted random digit dialing telephone methodology. A cross-sectional telephone survey of 1662 households was conducted in 18 of the 36 counties using the US Food Security Survey Module. FINDINGS: Twenty-one percent of Lower Delta households were food insecure, double the 2000 nationwide rate of 10.5%. Within the Lower Delta, groups with the highest rates of food insecurity were households with income below $15,000, black households, and households with children. The prevalence of hunger in Delta households with white children was 3.2% and in households with black children was 11.0%, compared to nationwide estimates of 0.3% and 1.6%. CONCLUSIONS: The Lower Mississippi Delta is characterized by a high prevalence of food insecurity and hunger. Future efforts to identify the household and community determinants of food insecurity to reduce its high prevalence are indicated.     

Food Insecurity Is Linked to a Food Environment Promoting Obesity in Households With Children

ObjectiveTo determine the extent to which the presence and accessibility of healthful and less healthful foods in children's homes vary with level of food security.MethodsA total of 41 parents or primary caregivers who had at least 1 child ages 2–13 and resided in a low-income area with limited food access completed a home food inventory and a validated measure assessing household food security.ResultsCompared with food-secure participants, marginal or low/very low food-secure caregivers reported significantly more obesity-promoting foods in the home, more microwavable or quick-cook frozen foods, and greater access to less healthful foods in the kitchen (all Ps < .05).Conclusions and ImplicationsGiven the greater presence and accessibility of less healthful foods, targeting home food environment may improve diet quality and health status in children of low-income, food insecure households.     

Food Insecurity Is Associated with Overweight in Children Younger than 5 Years of Age

Both household food insecurity and childhood overweight are serious public health problems that appear to be paradoxically correlated. This study examines the relationship between overweight and household food insecurity with/without hunger in low-income children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. Weight, height, and household food insecurity data were collected on 8,493 children ages 1 month to 5 years and analyzed by sex and age groups using logistic regression to model the odds of being overweight (weight for length or body mass index [calculated as kg/m²] for age ≥95th percentile) given household food insecurity status, controlling for race/ethnicity and maternal education. Analyses were stratified by age and sex because interaction terms with household food insecurity were significant (P<0.10). In this sample, prevalence of household food insecurity was 30.7% (8.3% with hunger) and 18.4% were overweight. Among girls younger than 2 years of age, household food insecurity was associated with reduced odds of overweight compared with food-secure households (odds ratio=0.65; 95% confidence interval: 0.47 to 0.88); hunger status did not alter this association. Among 2- to 5-year-old girls, there was no overall significant association between household food insecurity and overweight; however, household food insecurity with hunger was positively associated with overweight compared with those from food-secure households (odds ratio=1.49; 95% confidence interval: 1.06 to 2.10). No association between household food insecurity and overweight was found among boys. These findings suggest an association between household food insecurity and overweight prevalence in this low-income population. However, sex and age appear to modify both the magnitude and direction of the association.     

Prevalence of Food Insecurity Among Cancer Survivors in the United States: A Scoping Review

BackgroundMedical financial hardship is an increasingly common consequence of cancer treatment and can lead to food insecurity. However, food security status is not routinely assessed in the health care setting, and the prevalence of food insecurity among cancer survivors is unknown.ObjectiveThis scoping review aimed to identify the prevalence of food insecurity among cancer survivors in the United States before the COVID-19 pandemic.MethodsFive databases (PubMed, Scopus, CINAHL [Cumulative Index to Nursing and Allied Health Literature], Web of Science, and ProQuest Dissertations and Theses) were systematically searched for articles that reported on food security status among US patients receiving active cancer treatment or longer-term cancer survivors and were published between January 2015 and December 2020.ResultsAmong the 15 articles meeting the inclusion criteria, overall food insecurity prevalence ranged from 4.0% among women presenting to a gynecologic oncology clinic to 83.6% among patients at Federally Qualified Health Centers. Excluding studies focused specifically on Federally Qualified Health Center patients, prevalence of food insecurity ranged from 4.0% to 26.2%, which overlaps the food insecurity prevalence in the general US population during the same time period (range, 10.5% to 14.9%). Women were more likely than men to report being food insecure, and the prevalence of food insecurity was higher among Hispanic and Black patients compared with non-Hispanic White patients.ConclusionsGiven significant heterogeneity in study populations and sample sizes, it was not possible to estimate an overall food insecurity prevalence among cancer survivors in the United States. Routine surveillance of food security status and other social determinants of health is needed to better detect and address these issues.     

Household Crowding and Food Insecurity Among Inuit Families With School-Aged Children in the Canadian Arctic

Objectives. We examined the relation of household crowding to food insecurity among Inuit families with school-aged children in Arctic Quebec.Methods. We analyzed data collected between October 2005 and February 2010 from 292 primary caregiver–child dyads from 14 Inuit communities. We collected information about household conditions, food security, and family socioeconomic characteristics by interviews. We used logistic regression models to examine the association between household crowding and food insecurity.Results. Nearly 62% of Inuit families in the Canadian Arctic resided in more crowded households, placing them at risk for food insecurity. About 27% of the families reported reducing the size of their children’s meals because of lack of money. The likelihood of reducing the size of children’s meals was greater in crowded households (odds ratio = 3.73; 95% confidence interval = 1.96, 7.12). After we adjusted for different socioeconomic characteristics, results remained statistically significant.Conclusions. Interventions operating across different levels (community, regional, national) are needed to ensure food security in the region. Targeting families living in crowded conditions as part of social and public health policies aiming to reduce food insecurity in the Arctic could be beneficial.Inadequate housing conditions (e.g., crowding and structural damage) are prevalent among First Nations and Inuit communities in Canada and elsewhere.1 In Nunavik, the Inuit homeland in Arctic Quebec, Canada, the government promoted the relocation of many Inuit families to fledgling communities during the 1950s. Relocated families were moved to small, poorly heated and insulated accommodations. Since then, different programs have been designed by the federal, provincial, territorial, and regional governments to address the housing problem in Nunavik and across the Canadian Arctic.2 At present, more than 90% of the Nunavik population has reported living in social (subsidized) housing.3 In this region, social housing units are allocated locally through a point-based system set according to specific criteria, so that applicants most in need are given first priority (e.g., families with lower income, with young children, and living in overcrowded dwellings).2 Rent is set according to household income, while also considering the cost of living.4 Thus, in Nunavik, housing tenure does not differentiate between households on the basis of financial security or income level, given that nearly all of the population resides in social housing. Such organization rather highlights the high degree of financial need throughout this population and a limited private residential market unattainable by most of the population.Household overcrowding, generally defined as more than 1 person per room,5 is particularly problematic in Nunavik. According to Statistics Canada, 49% of the 2006 population lived in overcrowded houses.5 Often, overcrowding is approached as a consequence of economic difficulties. Living in smaller homes or in shared accommodation has been known as a way to lower living costs to dedicate the available financial resources to other basic necessities.6 In such situations, overcrowded households may experience higher food insecurity as a result of a precarious economic situation. In the particular case of Nunavik, however, crowding is a direct consequence of an underlying, and persistent, lack of housing. Household crowding in Nunavik is not only a product of financial difficulties but also an effect of the rapidly growing and young population. Between 2001 and 2006, the population in Nunavik increased by 12% compared with 4% for the province of Quebec. During the past 3 decades, the population has doubled from 5860 in 1986 to 12 090 in 2011.7 In 2008, it was estimated that more than 900 new housing units were needed, but only 239 units were constructed.8 The housing backlog is further compounded by high costs of construction and short building seasons.The housing situation in Nunavik and throughout the Canadian Arctic raises concerns, in terms of both public health and the health of each individual resident, especially that of children.9–14 Indeed, studies have shown that household crowding is associated with poorer respiratory health, especially among children.12,15 In crowded dwellings, the lack of privacy and the difficulty of withdrawing from (unwanted) social interactions may limit the ability of controlling one’s home situation and lead to “overarousal.”16 Household crowding also has been identified as eliciting chronic stress responses in adults,17 anger and depression18 with possible repercussions on behaviors,19–22 withdrawal,23 and reduced social support24 that, we contend, could influence household food insecurity.Food insecurity occurs when it is not possible to obtain safe, sufficient, and nutritiously adequate foods for a healthy life in socially and culturally acceptable ways.25–27 Studies have shown that in a situation of food insecurity, adults generally first reduce their own food consumption. As the situation becomes more severe, children’s diets also will be reduced, particularly in low-income households with single mothers.28,29 In 2012, 14% of the households in Canada experienced food insecurity.30 In Canadian Arctic communities, food insecurity is high: 62.2% and 31.6% of children live in food-insecure households in Nunavut and Northwest Territories, respectively.30 In Nunavik, the proportion of Inuit children experiencing food insecurity reached 30% in 2006.31 Studies emphasize that a reduction of the quality in diet and nutrient intake resulting from food insecurity is linked to various health issues in children, including poor health,25,32–34 developmental delays,35 and poor mental health.36Access to food products supplied from southern regions of Quebec comes at a very high cost to Nunavik, with an average price 57% higher than in the provincial capital.37 Despite efforts to redress this situation, food costs remain very high and often inaccessible to many Nunavik families who must resort to reducing the amount of food supplies or buying products of lower nutritional quality,38 which compromises health and well-being.36,37,39In a study conducted among low-income families in the United States, Cutts et al.40 found a higher risk of food insecurity and child food insecurity in households with higher housing insecurity. In their study, crowding and multiple moves were considered as indicators of housing insecurity. This association was independent of maternal and family characteristics such as education and household employment. In a recent study involving Inuit households from Nunavut, in the eastern Canadian Arctic, Huet et al.41 reported higher food insecurity among Inuit living in overcrowded households and in houses requiring major repairs. This observation, however, was based on bivariate associations between housing conditions and food insecurity and did not account for other factors such as socioeconomic conditions. These studies nonetheless suggest that food insecurity is not only explained in terms of low socioeconomic status and poverty.40,42We examined whether household crowding was associated with food insecurity among Inuit families with school-aged children, independently of socioeconomic disadvantage.     

Prevalence and Correlates of Food Insecurity Among Students Attending a Midsize Rural University in Oregon

ObjectiveTo examine the prevalence and identify correlates of food insecurity among students attending a rural university in Oregon.MethodsCross-sectional nonprobability survey of 354 students attending a midsize rural university in Oregon during May, 2011. The main outcome was food insecurity measured using the US Department of Agriculture Household Food Security Survey Module: 6-Item Short Form. Socioeconomic and demographic variables were included in multivariate logistic regression models.ResultsOver half of students (59%) were food insecure at some point during the previous year. Having fair/poor health (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.07–4.63), being employed (OR, 1.73; 95% CI, 1.04–2.88), and having an income < $15,000/y (OR, 2.23; 95% CI, 1.07–4.63) were associated with food insecurity. In turn, good academic performance (grade point average of ≥ 3.1) was inversely associated with food insecurity.ConclusionsFood insecurity seems to be a significant issue for college students. It is necessary to expand research on different campus settings and further strengthen support systems to increase access to nutritious foods for this population.     

Local-Level Immigration Enforcement and Food Insecurity Risk among Hispanic Immigrant Families with Children: National-Level Evidence

Local-level immigration enforcement generates fear and reduces social service use among Hispanic immigrant families but the health impacts are largely unknown. We examine the consequence of 287(g), the foundational enforcement program, for one critical risk factor of child health—food insecurity. We analyze nationally representative data on households with children from pooled cross-sections of the Current Population Survey Food Supplemental Survey. We identify the influence of 287(g) on food insecurity pre-post-policy accounting for metro-area and year fixed-effects. We find that 287(g) is associated with a 10 percentage point increase in the food insecurity risk of Mexican non-citizen households with children, the group most vulnerable to 287(g). We find no evidence of spillover effects on the broader Hispanic community. Our results suggest that local immigration enforcement policies have unintended consequences. Although 287(g) has ended, other federal-local immigration enforcement partnerships persist, which makes these findings highly policy relevant.     

Food Insecurity Pre- and Post the COVID-19 Pandemic and Economic Crisis in Lebanon: Prevalence and Projections

The coronavirus (COVID-19) pandemic has had serious repercussions on the global economy, work force, and food systems. In Lebanon, the pandemic overlapped with an economic crisis, which threatened to exacerbate food insecurity (FI). The present study aims to evaluate the trends and projections of FI in Lebanon due to overlapping health and economic crises. Data from Gallup World Poll (GWP) 2015–2017 surveys conducted in Lebanon on nationally representative adults (n = 3000) were used to assess FI trends and explore its sociodemographic correlates. Predictive models were performed to forecast trends in FI (2018–2022), using GWP data along with income reduction scenarios to estimate the impact of the pandemic and economic crises. Pre crises, trend analyses showed that FI could reach 27% considering wave year and income. Post crises, FI was estimated to reach on average 36% to 39%, considering 50–70% income reduction scenarios among Lebanese population. FI projections are expected to be higher among females compared to males and among older adults compared to younger ones (p < 0.05). These alarming findings call for emergency food security policies and evidence-based programs to mitigate the burden of multiple crises on the FI of Lebanese households and promote resilience for future shocks.     

Food Insecurity,Neighborhood Food Access,and Food Assistance in Philadelphia

An estimated 17.6 million American households were food insecure in 2012, meaning they were unable to obtain enough food for an active and healthy life. Programs to augment local access to healthy foods are increasingly widespread, with unclear effects on food security. At the same time, the US government has recently enacted major cuts to federal food assistance programs. In this study, we examined the association between food insecurity (skipping or reducing meal size because of budget), neighborhood food access (self-reported access to fruits and vegetables and quality of grocery stores), and receipt of food assistance using the 2008, 2010, and 2012 waves of the Southeastern Pennsylvania Household Health Survey. Of 11,599 respondents, 16.7 % reported food insecurity; 79.4 % of the food insecure found it easy or very easy to find fruits and vegetables, and 60.6 % reported excellent or good quality neighborhood grocery stores. In our regression models adjusting for individual- and neighborhood-level covariates, compared to those who reported very difficult access to fruits and vegetables, those who reported difficult, easy or very easy access were less likely to report food insecurity (OR 0.62: 95 % CI 0.43–0.90, 0.33: 95 % CI 0.23–0.47, and 0.28: 95 % CI 0.20–0.40). Compared to those who reported poor stores, those who reported fair, good, and excellent quality stores were also less likely to report food insecurity (OR 0.81: 95 % CI 0.60–1.08, 0.58: 95 % CI 0.43–0.78, and 0.43: 95 % CI 0.31–0.59). Compared to individuals not receiving food assistance, those receiving Supplemental Nutrition Assistance Program (SNAP) benefits were significantly more likely to be food insecure (OR 1.36: 95 % CI 1.11–1.67), while those receiving benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (OR 1.17: 95 % CI 0.77–1.78) and those receiving both SNAP and WIC (OR 0.84: 95 % CI 0.61–1.17) did not have significantly different odds of food insecurity. In conclusion, better neighborhood food access is associated with lower risk of food insecurity. However, most food insecure individuals reported good access. Improving diet in communities with high rates of food insecurity likely requires not only improved access but also greater affordability.     

Family Structure and Child Food Insecurity

Objectives. We examined whether food insecurity was different for children in cohabiting or repartnered families versus those in single-mother or married-parent (biological) families.Methods. We compared probabilities of child food insecurity (CFI) across different family structures in 4 national data sets: the Early Childhood Longitudinal Study—Birth Cohort (ECLS-B), the Fragile Families and Child Wellbeing Study (FFCWS), the Early Childhood Longitudinal Study—Kindergarten Cohort (ECLS-K), and the Panel Study of Income Dynamics—Child Development Supplement (PSID-CDS).Results. Unadjusted probabilities of CFI in cohabiting or repartnered families were generally higher than in married-biological-parent families and often statistically indistinguishable from those of single-mother families. However, after adjustment for sociodemographic factors, most differences between family types were attenuated and most were no longer statistically significant.Conclusions. Although children whose biological parents are cohabiting or whose biological mothers have repartnered have risks for food insecurity comparable to those in single-mother families, the probability of CFI does not differ by family structure when household income, family size, and maternal race, ethnicity, education, and age were held at mean levels.In 2012, 10% of US households had food-insecure children, meaning that access to adequate food for these children was limited by their households’ lack of money and other resources.1 Food insecurity poses a serious risk to the health and well-being of children; it has been linked to behavioral problems, developmental risk, poor health in infants and toddlers,2,3 and negative academic, social, and psychological outcomes in older children and adolescents.4,5Traditionally, households headed by single mothers have had the highest rates of child food insecurity (CFI) whereas married-couple households have had the lowest rates: 18.7 versus 6.3%, according to the most recent data from the United States Department of Agriculture (USDA).1 However, federal reports do not provide data on CFI in households characterized by other family structures, which are of increasing prevalence and interest. The most common of these family structures is cohabitation. Today, one fifth of all children in the United States are born to cohabiting, but not married, parents.6–8 There is also little information on CFI in repartnered families, where only 1 of the 2 adults heading the household is a biological parent of the children in the household. Although there are few consistent estimates of the prevalence of these types of families in the United States, US Census Bureau data suggest that between 10% and 20% of children currently live in repartnered families and that more than one third of children will experience this type of living arrangement.9,10 National reports do not provide estimates of CFI for this group; rather, families in which 1 biological parent has remarried are currently grouped with families in which the biological parents of the child are married to each other.1There is good reason to believe that the prevalence of CFI in cohabiting or repartnered families may be very different from its prevalence in married-biological-parent families. Most studies find that cohabiting unions are less stable and that these families have fewer resources than married-parent families,11–13 although findings on child well-being in cohabitating families are mixed. Regarding repartnered families, new partners may contribute resources, thereby improving food security,14 but previous research suggests that stepparents may underinvest in nonbiological children, because they may be providing resources to their prior biological children in other households or because they are less committed to nonbiological children.15–18 Additionally, the instability that often accompanies repartnering may be harmful for a child’s well-being.19,20Economic models for the dynamics of food insecurity21,22 suggest that decisions about food consumption are driven in part by families’ past and future resources and their ability to maintain consistent consumption over time, implying that stability and consistency may be as important for children’s food security as absolute level of resources. Thus, although single-mother families may have the fewest resources, they may not necessarily have a higher risk of food insecurity than these other nontraditional family types (cohabiting parents and repartnered parents), because of the potential instability of these family structures. A handful of previous studies have examined food insecurity across different family structures; however, these studies are dated and have relied on limited measures of food insecurity.11,23–26 The USDA’s 18-item food security module (FSM) is considered the best measure of household food security. Previous studies, however, have often used measures of food insecurity based on 3 or fewer questions, making them of questionable validity. As a consequence, most studies have not been able to identify CFI, which involves limited access to adequate food specifically among children. Separately examining CFI is important, as parents often act to protect children from food insecurity by reducing their own food intake,1 implying that general household measures could indicate food insecurity when children themselves may not be food insecure. One recent study of family change, which used the full 18-item FSM, found that transition into a maternal union was associated with lower household food insecurity. However, this study did not investigate CFI, nor did it report on rates of food insecurity by different family structures.27We investigated 2 complementary research questions: (1) How do rates of CFI for children in cohabiting and repartnered homes compare with those for children living with married biological parents or single mothers? (2) Do any differences in the rates of food insecurity among children in different family structures persist after adjustment for sociodemographic factors typically associated with both family structure and food insecurity? Our study makes a number of concrete contributions. First, we used a highly reliable and valid measure of CFI: the 8 child-referenced items from the USDA’s FSM. Second, our first research question was used to generate comprehensive and contemporary epidemiological evidence about potential differences (or similarities) in rates of CFI in different family types on the basis of analyses of 4 national data sets, an important contribution given limitations in current federal reporting. Last, our adjusted models (which examined differences in CFI between families that were average in all other regards) have the greatest potential to inform policies and programs that aim to eliminate CFI.