Hunger in Midwestern Inner-city Young Children

OBJECTIVE: To determine the characteristics of hunger in young children who attend ambulatory pediatric clinics in a midwestern city. DESIGN: Consecutive sample. SETTING: Ambulatory pediatric clinics of an inner-city teaching hospital. PARTICIPANTS: English-speaking caregivers of 2578 children younger than 5 years. MAIN OUTCOME MEASURE: Structured survey measures of hunger, family characteristics, assistance program use, child feeding practices, and anthropometrics. RESULTS: In this population, 171 (6.6%) were hungry, and 842 (32.7%) were at risk for hunger. Hunger status was associated with increased age (P<.001), decreased maternal education level (P=.013), maternal nonwhite race (P<.002), a history of homelessness (P<.001), and parental unemployment (P<.001). Hunger status was associated with use of Aid to Families with Dependent Children (P<.001) and food stamps (P<.001) but not with participation in The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Results of anthropometrics indicated that mean growth percentiles were no different between hunger categories. CONCLUSIONS: Housing, dietary, and family characteristics are identifiable risk factors for early childhood hunger. Hunger cannot be identified, however, using anthropometrics. It is disconcerting that fewer hungry children and children at risk for hunger participate in WIC compared with other programs. These data suggest the potential for more aggressive identification and intervention at the primary care and social service levels to benefit hungry children.