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Food insecurity associated with poorer health status in children with congenital heart disease

Food insecurity associated with poorer health status in children with congenital heart disease
Photo by Cht Gsml / Unsplash
Key Takeaway
Consider screening for food insecurity in children with CHD, as it associates with poorer reported health status.

A cross-sectional analysis of 2023 National Survey of Children's Health data examined 53,477 U.S. children under 17 years, including 1,233 (2%) with congenital heart disease. The study compared children with and without food insecurity, assessing overall health status as fair or poor versus good, very good, or excellent.

Children with CHD had higher prevalence of food insecurity (35% vs 27% without CHD), with adjusted odds ratio of 1.49 (95% CI: 1.05-2.12; p=0.005). Within the CHD subgroup, those experiencing food insecurity had 3.91 times higher odds of reporting fair or poor health status (95% CI: 1.70-9.02; p=0.001), with 5% of the CHD subgroup reporting fair/poor health overall.

Safety and tolerability data were not reported. Key limitations include the observational, cross-sectional design that prevents causal inference and reliance on survey data. The study notes limited prior research on food insecurity's impact on health status specifically among children with CHD.

Practice relevance is restrained: these associations suggest food insecurity screening might identify children with CHD at risk for poorer health outcomes, but targeted interventions require further study. The findings highlight socioeconomic disparities but cannot establish that addressing food insecurity directly improves health status in this population.

Study Details

EvidenceLevel 5
PublishedApr 2026
View Original Abstract ↓
Background: Children with congenital heart disease (CHD) require specialized care and may face worse outcomes if they experience food insecurity (FI). FI is associated with poor nutrition, hospitalizations, and developmental delays, compounding cardiac risks. Limited research evaluated impact of FI on health status among children with CHD. This study examines socioeconomic factors and the relationship between FI and health status in children with CHD. Methods: 2023 National Survey of Children?s Health (NSCH) data were used to compare rates of FI between children ages < 17 years with and without CHD and to assess overall health status of those with CHD. Descriptive, univariate, and multivariable logistic regression were utilized. Results: Among 53,477 children, 1,233(2%) had CHD. FI was reported in 35% of children with CHD vs. 27% without CHD(p=0.005). After adjustment, children with CHD had higher odds of FI (OR 1.49; 95% CI: 1.05?2.12). Hispanic ethnicity, residence in Midwest or South, lower household education, and lower poverty index were significantly associated with FI. Households receiving food assistance had higher FI. Living in grandparent household was associated with lower odds of FI. Within the CHD subgroup, 5% reported fair or poor health. Children with CHD experiencing FI had greater odds of fair or poor health than those without FI (OR 3.91, 95% CI 1.70?9.02; p=0.001). Conclusions: Children with CHD face higher odds of FI, which is strongly associated with worse reported health. Addressing socioeconomic vulnerability and FI may improve outcomes and reduce disparities in this high-risk population through targeted screening and intervention strategies nationwide. Keywords: Congenital Heart Disease, Food Insecurity Screening, National Survey of Children?s Health (NSCH), Health Disparities
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