Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Dec 1;152(6):e2023061750.
doi: 10.1542/peds.2023-061750.

Food Insecurity and Experiences of Discrimination Among Caregivers of Hospitalized Children

Alexis M Cacioppo  1 , Victoria Winslow  2 , Emily M Abramsohn  2 , Jyotsna S Jagai  2 , Jennifer A Makelarski  2 , Elaine Waxman  3 , Kristen Wroblewski  4 , Stacy Tessler Lindau  5
Affiliations
Randomized Controlled Trial

Food Insecurity and Experiences of Discrimination Among Caregivers of Hospitalized Children

Alexis M Cacioppo et al. Pediatrics. .

Abstract

Background and objectives: Pediatric hospitals are adopting strategies to address food insecurity (FI), a stigmatizing condition, among families with children. We hypothesized that parents and other caregivers ("caregivers") from households with FI or marginal food security (MFS) are more likely to experience discrimination during their child's hospitalization.

Methods: We analyzed data from 319 caregivers of children admitted to an urban, academic children's hospital and randomly assigned to the control arm of the double-blind randomized controlled CommunityRx-Hunger trial (November 2020 to June 2022, NCT R01MD012630). Household food security in the 30 days before admission and discrimination during hospitalization were measured with the US Household Food Security Survey and the Discrimination in Medical Settings Scale, respectively. We used logistic regression to model the relationship between food security status and discrimination, adjusting for gender, race, ethnicity, income, and partner status.

Results: Most participants were African American or Black (81.5%), female (94.7%), and the parent of the hospitalized child (93.7%). FI and MFS were prevalent (25.1% and 15.1%, respectively). Experiences of discrimination during a child's hospitalization were prevalent (51.9%). Caregivers with FI had higher odds than caregivers with food security of experiencing discrimination (adjusted odds ratio = 2.0, 95% confidence interval 1.1-3.6, P = .03); MFS was not significantly associated with discrimination (P = .25). Compared with food secure caregivers, those with FI had higher odds of 5 of 7 experiences of discrimination assessed.

Conclusions: Among parents and other caregivers, household FI is associated with experiences of discrimination during a child's hospitalization.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: Dr Lindau discloses that she is a contributor to UpToDate, Inc, which generated royalties <$100/year to her laboratory at the University of Chicago (2019, 2020). Dr Lindau is also an unpaid advisor to and holds stock in Unite USA Inc, and holds debt in another corporate entity unrelated to the content of this manuscript. Dr Lindau and her spouse hold stocks and mutual funds managed by third parties. All other co-authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Participants who did not complete relevant items were excluded from this analysis. Caregivers’ experiences of discrimination were dichotomized with any experiences of discrimination corresponding to raw scores >7 and no experiences of discrimination corresponding to raw scores = 7.
FIGURE 2
FIGURE 2
Participants who did not complete relevant items were excluded from this analysis. Covariates in adjusted models were sex, race and ethnicity, income, and partner status; an additional seven participants were excluded based on missing data for these covariates. X-axis uses a log2 scale.
See this image and copyright information in PMC

References

    1. Coleman-Jensen A, Rabbitt MP, Hales L, Gregory CA. Definitions of food security. Available at: https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-.... Accessed December 15, 2021
    1. Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household food security in the United States in 2021. Available at: https://www.ers.usda.gov/webdocs/publications/104656/err-309.pdf. Accessed September 25, 2022
    1. Gundersen C, Ziliak JP. Food insecurity and health outcomes. Health Aff (Millwood). 2015;34(11):1830–1839 - PubMed
    1. Shankar P, Chung R, Frank DA. Association of food insecurity with children’s behavioral, emotional, and academic outcomes: a systematic review. J Dev Behav Pediatr. 2017;38(2):135–150 - PubMed
    1. Earnshaw VA, Karpyn A. Understanding stigma and food inequity: a conceptual framework to inform research, intervention, and policy. Transl Behav Med. 2020;10(6):1350–1357 - PMC - PubMed

Publication types