Urban-rural disparities in food insecurity and weight status among children in the United States

Authors: DAVE, JAYNA - Children'S Nutrition Research Center (CNRC); CHEN, TZUAN - University Of Houston; CASTRO, ALEXANDRA - Children'S Nutrition Research Center (CNRC); WHITE, MAMIE - Children'S Nutrition Research Center (CNRC); ONUGHA, ELIZABETH - Texas Children'S Hospital; ZIMMERMAN, SLOANE - Baylor College Of Medicine; Thompson, Deborah - Debbe

Submitted to: Nutrients
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/3/2024
Publication Date: 7/4/2024
Citation: Dave, J.M., Chen, T.A., Castro, A.N., White, M.A., Onugha, E.A., Zimmerman, S., Thompson, D.J. 2024. Urban-rural disparities in food insecurity and weight status among children in the United States. Nutrients. 16(13):Article 2132. https://doi.org/10.3390/nu16132132.
DOI: https://doi.org/10.3390/nu16132132

Interpretive Summary: Where children live (urban vs. rural) affects their health, but this hasn't been studied much in relation to food insecurity. This study looked at the differences in food insecurity and weight among U.S. children based on whether they live in cities or rural areas. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2016, we examined children in three age groups (2-5, 6-11, and 12-17 years old). We found that children aged 6-11 living in cities were more likely to face food insecurity compared to those in rural areas. The study showed significant links between weight and food insecurity for urban children across all age groups, but not for rural children, with these trends being more noticeable in older kids. Since food insecurity is connected to higher obesity rates, especially in urban children, this study emphasizes the need to include strategies to improve food security in future obesity prevention programs.

Technical Abstract: Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban-rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 with three age groups of children (2-5, 6-11, and 12-17 years old), the associations of weight status and child and household food security status by urban-rural residence were examined using Rao-Scott Chi-square tests. Statistical significance was set at p<0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6-11 years. The associations between children's weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs.