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Early Childhood Hunger in Minneapolis: Impact on Growth, Obesity, Nutritional Status and Development. Diana Becker Cutts, MD Joni Geppert, MPH, RD, LN Office of Pediatric Research and Advocacy Hennepin County Medical Center. Definition of Hunger.

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Early Childhood Hunger in Minneapolis: Impact on Growth, Obesity, Nutritional Status and Development

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Early childhood hunger in minneapolis impact on growth obesity nutritional status and development l.jpg

Early Childhood Hunger in Minneapolis: Impact on Growth, Obesity, Nutritional Status and Development

Diana Becker Cutts, MD

Joni Geppert, MPH, RD, LN

Office of Pediatric Research and Advocacy

Hennepin County Medical Center


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Definition of Hunger

Hunger is defined as the uneasy or painful sensation caused by a recurrent or involuntary lack of food and is a potential, although not necessary, consequence of food insecurity.


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Definition of Food Insecurity

  • Food Insecurity: Occurs whenever the availability of nutritionally adequate and safe food or the ability to acquire acceptable foods in socially acceptable ways is limited or uncertain.

  • Child Food Insecurity: Occurs when households with children also reduce the quality and/or quantity of children’s food intake because they lack sufficient food or money to buy food.


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Food Insecurity Measures

  • Community Childhood Hunger Identification Project (C-CHIP)

  • Cornell Radimer Scale

  • USDA Food Security Measurement


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USDA Scale Screen One

  • We worried whether our food would run out before we got money to buy more.

  • The food we bought just didn’t last and we didn’t have money to get more.

  • We couldn’t afford to eat balanced meals.

  • We relied on only a few kinds of low cost food to feed our children because we were running out of money to buy food.**

  • We couldn’t feed our children a balanced meal because we couldn’t afford that.**


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USDA Scale Screen 2

  • Our children were not eating enough because we just couldn’t afford enough food.**

  • Since last year did you or other adults in your household ever cut the size of your meals or skip meals because there wasn’t enough money for food? 2a. How often did this happen?

  • Eat less than you felt you should because there wasn’t enough money to buy food?

  • Lose weight because you didn’t have enough money for food? How often did this happen?

  • Did adults not eat for a whole day? 5a. How often did this happen?


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USDA Scale Stage 3 (Child Food Insecurity)

  • The next questions are about children living in the household who are under 18 years old.

  • Since last year did you ever cut the size of your child’s meals because there wasn’t enough money for food?**

  • Child ever skip meals because there wasn’t enough money for food? 2b. How often did this happen?**

  • Child ever hungry because you couldn't afford more food.**

  • Child ever not eat for a whole day because there wasn’t enough money for food.**


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Food Insecurity Scoring


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Prevalence of Household Food Insecurity


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Children’s Sentinel Nutrition Assessment Program (C-SNAP)

  • National, multi-site study to measure hunger and malnutrition in children under three years of age starting September 1998 through present.

  • Over 15,000 families surveyed in English, Spanish and Somali (Minneapolis only) in ambulatory pediatric clinics and emergency department settings in Minneapolis, Little Rock, Boston, D.C., Los Angeles and Baltimore


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C-SNAP Goal

  • To provide information based on clinical research findings to help federal and state policy makers, physicians, service providers and others make informed decisions regarding welfare reform policies and social welfare programs that affect low-income families and young children.


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Food Insecurity in National CSNAP Sample


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Unadjusted Food Insecurity Trends in HCMC Families with Young Children by Year of Study


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Unadjusted Childhood Hunger Trends in HCMC Families with Young Children by Year of Study


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TANF Sanctions and Food Insecurity for National Sample


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Food Stamp Sanctions and Food Insecurity in National Sample


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Caregiver-Report Measures(Unadjusted by covariates)Aug 1998 - Dec 2000; 2,718 families at six sites

p = .05


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Caregivers of Infants Who Receive WIC

  • Food Security (covariate controls)

    1.4 times more likely to live in food secure households

    • AOR=1.42, 95% CI, 1.01,2.00, p = .04


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Number of Places Lived in Last Year

Aug 1998 - Dec 2000; 2,718 families at six sites


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Housing Instability

  • Temporary Living Situation

  • Moved more than 3 times in last year


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# places lived in last yr.>3 places 1-2 places 95% CI p-valueOutcomes OR OR OR

Food Insecurity1.92 1.00 (1.50, 2.47) <.0001

Effect of Housing Instability on

Food Insecurity

Aug 1998 - Dec 2000; 2,718 families at six sites


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Factors Associated with Early Childhood Hunger

  • Homelessness, Frequent Moves, Crowding

  • US Born Child, Latina Mom

  • Children of Color

  • Mothers Marital Status

  • Mothers Education

  • Employment

  • Child’s age

  • Changes in TANF or Food Stamp Program Benefits


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