Nutrition security,diet quality,and food assistance program use among food insecure households with children: A cross-sectional analysis

Abstract

Background

While food insecurity (FI) assesses household access to sufficient food, increasing attention is being paid to nutrition security (NS), the ability to obtain health-promoting foods.

Aim

This cross-sectional analysis examined differences in sociodemographics, diet quality, and health status between food insecure families with low versus high NS and assessed if FI and NS severity was associated with food assistance program use.

Methods

Data were obtained from the 2023 Massachusetts Statewide Food Access Survey of >3000 adults. FI was assessed using the United States Department of Agriculture 18-item Household Food Security Module, NS via a validated four-item scale, and diet quality via the Prime Diet Quality Score (PDQS). FI and NS were analyzed as binary and continuous variables. Inferential statistics assessed group differences. Logistic regression assessed associations between the severity of FI and NS and food assistance program use.

Summary

Households with FI, ≥1 child (≤18 years), and annual income ≤$50,000 (n = 335) were included. Forty-three percent reported low NS. Low (vs. high) household NS was associated with a higher prevalence of child-level FI (79% vs. 43%, P < 0.001), SNAP use (83% vs. 70%, P = 0.009), food pantry use (69% vs. 44%, P < 0.001), adult overweight/obesity (39% vs. 17%, P < 0.001), and lower adult PDQS (43 ± 5.1 vs. 44 ± 4.3, P  =  0.023), indicating lower diet quality. More severe household FI and lower NS were associated with higher odds of SNAP and food pantry use (P < 0.001). These findings support expanding food assistance programs to increase nutritious food access for families with children before food and nutrition insecurity become severe.