Food Security, Poverty, and Human Development in the United States

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Abstract

Access to food is essential to optimal development and function in children and adults. Food security, food insecurity, and hunger have been defined and a U.S. Food Security Scale was developed and is administered annually by the Census Bureau in its Current Population Survey. The eight child-referenced items now make up a Children's Food Security Scale. This review summarizes the data on household and children's food insecurity and its relationship with children's health and development and with mothers' depressive symptoms. It is demonstrable that food insecurity is a prevalent risk to the growth, health, cognitive, and behavioral potential of America's poor and near-poor children. Infants and toddlers in particular are at risk from food insecurity even at the lowest levels of severity, and the data indicate an "invisible epidemic" of a serious condition. Food insecurity is readily measured and rapidly remediable through policy changes, which a country like the United States, unlike many others, is fully capable of implementing. The food and distribution resources exist; the only constraint is political will.

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Breastfeeding and the use of human milk.

Lawrence Gartner, Jane I. Morton, Ruth Lawrence … (2005)

Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in the clinical management of breastfeeding. This policy statement on breastfeeding replaces the 1997 policy statement of the American Academy of Pediatrics and reflects this newer knowledge and the supporting publications. The benefits of breastfeeding for the infant, the mother, and the community are summarized, and recommendations to guide the pediatrician and other health care professionals in assisting mothers in the initiation and maintenance of breastfeeding for healthy term infants and high-risk infants are presented. The policy statement delineates various ways in which pediatricians can promote, protect, and support breastfeeding not only in their individual practices but also in the hospital, medical school, community, and nation.

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Housing instability and food insecurity as barriers to health care among low-income Americans.

Margot Kushel, Reena Gupta, Lauren Gee … (2006)

Homelessness and hunger are associated with poor health outcomes. Housing instability and food insecurity describe less severe problems securing housing and food. To determine the association between housing instability and food insecurity and access to ambulatory health care and rates of acute health care utilization. Secondary data analysis of the National Survey of American Families. 16,651 low-income adults. Self-reported measures of past-year access: (1) not having a usual source of care, (2) postponing needed medical care, or (3) postponing medication; and past-year utilization: (1) not having an ambulatory care visit, (2) having emergency department (ED) visits, or (3) inpatient hospitalization. 23.6% of subjects had housing instability and 42.7% had food insecurity. In multivariate logistic regression models, housing instability was independently associated with not having a usual source of care (adjusted odds ratio [AOR] 1.31, 95% confidence interval [CI] 1.08 to 1.59), postponing needed medical care (AOR 1.84, 95% CI 1.46 to 2.31) and postponing medications (AOR 2.16, 95% CI 1.70 to 2.74), increased ED use (AOR: 1.43, 95% CI 1.20 to 1.70), and hospitalizations (AOR 1.30, 95% CI 1.01 to 1.67). Food insecurity was independently associated with postponing needed medical care (AOR 1.74, 95% CI 1.38 to 2.21) and postponing medications (AOR 2.15, 95% CI 1.62 to 2.85), increased ED use (AOR 1.39, 95% CI 1.17 to 1.66), and hospitalizations (AOR 1.42, 95% CI 1.09 to 1.85). Housing instability and food insecurity are associated with poor access to ambulatory care and high rates of acute care. These competing life demands may lead to delays in seeking care and predispose to acute care.

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Housing and health: time again for public health action.

James K Krieger, Donna Higgins (2002)

Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing "Healthy Homes" programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing.