Influence of Household Environment and Food Security on Children's Physical Growth

Abstract

Background The guardians care and the amount and quality of resources are crucial for managing young childrens growth. However, gap in growth between children with different household environment still remains as major public health concerns among young Korean children who are facing rapid social changes. Considering that childrens growth is ultimately defined by the amount and quality of nutrition, the effect of household food security on childrens growth and interaction between their household environments should be studied

Objective This study aimed to identify the transition of childrens stunted growth and overweight growth between 2009 and 2012. The relationship between household food security and household income level was studied. In addition, the influence of parental socioeconomic status (SES) and child care environment and how it is changed by the food security in the household were analyzed.

Methods This study used the 4th (2009) and 5th (2010-2012) Korean Health and Nutritional Examination Surveys for data. Study participants were children aged 24 to 60 months old, except the one who had missing height or weight information or diagnosed with congenital heart disease. The significant influence of household income level on household food security was analyzed using logistic regression after controlling such variables as the characteristics of the head of the household, family member, household type, and external assistance related to food supplement or child care. Household food security reflecting households nutritional environment and economic circumstances, parental SES except household income level, and child care environment were used as the independent variables in the study of the influence of household environment on childrens physical growth. The 2006 World Health Organizations Children Growth Standards was used to identify normal and abnormal height and weight. A two-stage stratified systematic sampling method was applied in both logistic regression analyses.

Results The prevalence of stunted growth was lower than 2% in each year but the prevalence of overweight growth was higher than that of stunted growth in each year and the annual changes of the prevalence of overweight was more rapid to that of stunted growth. Household income level had a significant influence on determining household food security

the lower the household income, the more the household is likely to be in a food insecure status. Household food security, parental SES and child care environment exerted significant effects on both childrens height and weight. In particular, household food security, mothers educational level, and the use of child care facility were the most influential factors to childrens stunted growth, while the frequency of having meals with family member was distinctively significant to childrens overweight growth. Household food security and mothers educational level remained as the most influential factor on childrens stunted growth in all of the study models that applied interaction terms. In contrast, the frequency of having meals with family member remained as significant factor to childrens overweight growth after applying interaction between household food security and household environment. However, there were no significant interaction terms between household food security, parental SES, and child care environment.

Conclusions This study demonstrated that food secured environment, mothers educational level, and caregivers responsive care were important variables for young childrens normal growth. Therefore, multidimensional reviews of childrens household environments should be considered in child growth study. National policy in regard to child care assistance should take an approach in researching childrens nutritional environment and providing child care assistance service programs to household in food insecure status.