Food Security Status,WIC Participation,and Early Childhood Caries in a Nationally Representative Sample of Children |
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| Affiliation: | 1. Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX;2. Dental Hygiene Program, Austin Community College, Austin, TX;1. Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA;2. School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA;3. Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA;4. School of Medicine, University of Puerto Rico, San Juan, Puerto Rico;5. FDI Clinical Research, San Juan, Puerto Rico;6. Department of Biomedical and Nutritional Sciences, Center for Population Health, University of Massachusetts, Lowell, MA;1. Boston Combined Residency Program, Boston Children’s Hospital & Boston Medical Center, Boston, Massachusetts;2. Division of Gastroenterology, Hepatology, and Nutrition, The Children''s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;3. Trisomy 21 Program, Division of Developmental Behavioral Pediatrics, The Children''s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;4. Division of Endocrinology and Diabetes, The Children''s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;5. Johns Hopkins University School of Medicine, Baltimore, Maryland;1. Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA;2. Center for Public Health Nutrition, University of Washington, Seattle, WA;3. Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA;4. Department of Health Systems and Population Health, University of Washington, Seattle, WA;5. Department of Epidemiology, University of Washington School of Public Health, Seattle, WA;6. Washington State Department of Health, Olympia, WA;1. Bern University of Applied Sciences, Bern, Switzerland;2. Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore;3. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore;4. Université de Paris, CRESS, Inserm, Paris, France;5. Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;6. Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children''s Medical Institute, National University Hospital, National University Health System, Singapore;7. Duke-National University of Singapore Graduate Medical School, Singapore;8. Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore;9. Department of Pediatric Endocrinology, KK Women''s and Children''s Hospital, Singapore;10. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore;11. Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom;12. National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton, United Kingdom;13. Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;14. Folkhälsan Research Center, Helsinki, Finland;15. Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;16. Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Bern, Switzerland |
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| Abstract: | BackgroundDespite the potential role of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in mitigating the adverse effects of food insecurity on oral health, to our knowledge, no study has examined whether WIC participation could modify the association between food insecurity with caries in young children.ObjectiveOur aim was to investigate the impact of WIC participation in modifying the association between food insecurity and early childhood caries.DesignThis was a cross-sectional study.Participants/settingUsing 2011-2018 National Health and Nutrition Examination Survey data, children aged 2 through 5 years; with household income ≤185% of the Federal Poverty Level; and with data on WIC participation, food security, and dental examinations were included (n = 1,921).Study exposuresFood-security status and WIC participation were the study exposures.Main outcome measuresTotal and untreated dental caries were the main outcome measures.Statistical analysesLogistic regression examined associations of food security (household-level and child-level) and WIC participation with odds of caries. Interactions between food security and WIC participation were examined using multiplicative interaction terms.ResultsMarginal child food security was significantly related to higher odds of total caries in income-eligible WIC nonparticipants (odds ratio 1.92; 95% CI 1.07 to 3.46); however, this relationship was not observed in WIC participants. Furthermore, food insecurity was significantly associated with greater odds of untreated caries only among income-eligible WIC nonparticipants (odds ratio 1.79; 95% CI 1.12 to 2.85).ConclusionsIn this sample of preschool-aged children, the relationship of food insecurity with caries differed by WIC participation status. Findings suggest that WIC participation could improve the oral health of income-eligible children with lower levels of food security. |
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| Keywords: | Food security WIC participation Dental caries NHANES Early childhood |
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