Influence of household environment and food security on children's physical growth

다국어 초록 (Multilingual Abstract)

Background
The guardians’ care and the amount and quality of resources are crucial for managing young children’s growth. However, gap in growth between children with different household environment still remains as major public health concerns among young Korean children who are facing rapid social changes. Considering that children’s growth is ultimately defined by the amount and quality of nutrition, the effect of household food security on children’s growth and interaction between their household environments should be studied

Objective
This study aimed to identify the transition of children’s stunted growth and overweight growth between 2009 and 2012. The relationship between household food security and household income level was studied. In addition, the influence of parental socioeconomic status (SES) and child care environment and how it is changed by the food security in the household were analyzed.

Methods
This study used the 4th (2009) and 5th (2010-2012) Korean Health and Nutritional Examination Surveys for data. Study participants were children aged 24 to 60 months old, except the one who had missing height or weight information or diagnosed with congenital heart disease. The significant influence of household income level on household food security was analyzed using logistic regression after controlling such variables as the characteristics of the head of the household, family member, household type, and external assistance related to food supplement or child care.
Household food security reflecting household’s nutritional environment and economic circumstances, parental SES except household income level, and child care environment were used as the independent variables in the study of the influence of household environment on children’s physical growth. The 2006 World Health Organization’s Children Growth Standards was used to identify normal and abnormal height and weight. A two-stage stratified systematic sampling method was applied in both logistic regression analyses.

Results
The prevalence of stunted growth was lower than 2% in each year but the prevalence of overweight growth was higher than that of stunted growth in each year and the annual changes of the prevalence of overweight was more rapid to that of stunted growth. Household income level had a significant influence on determining household food security; the lower the household income, the more the household is likely to be in a food insecure status. Household food security, parental SES and child care environment exerted significant effects on both children’s height and weight. In particular, household food security, mothers’ educational level, and the use of child care facility were the most influential factors to children’s stunted growth, while the frequency of having meals with family member was distinctively significant to children’s overweight growth. Household food security and mothers’ educational level remained as the most influential factor on children’s stunted growth in all of the study models that applied interaction terms. In contrast, the frequency of having meals with family member remained as significant factor to children’s overweight growth after applying interaction between household food security and household environment. However, there were no significant interaction terms between household food security, parental SES, and child care environment.

Conclusions
This study demonstrated that food secured environment, mothers’ educational level, and caregivers’ responsive care were important variables for young children’s normal growth. Therefore, multidimensional reviews of children’s household environments should be considered in child growth study. National policy in regard to child care assistance should take an approach in researching children’s nutritional environment and providing child care assistance service programs to household in food insecure status.

목차 (Table of Contents)

• I. Introduction
• A. Study Background
• B. Study Objectives
• II. Theoretical Background
• A. Children's Growth
• B. Food Security
• C. Parental Socioeconomic Status
• D. Child Care Environment
• III. Methodology
• A. Data Source
• B. Study Participants
• C. Study Model
• D. Variables
• E. Statistical Analysis
• IV. Results
• A. General Characteristics of Study Participants
• B. Distribution of Stunting and Overweight: 2009-2012
• C. Correlation Analysis between Variables
• D. Relationship between Household Food Security and Household Income Level
• E. Influence of Parental SES, Household Food Security, and Child Care Environment on Children's Physical Growth
• 1. Influence of Household Food Security, Parental SES, and Child Care Environment on Children's Height
• 2. Influence of Household Food Security, Parental SES, and Child Care Environment on Children's Weight
• V. Discussion
• A. Household Food Security
• B. Household Environment
• C. Implications and Limitations
• VI. Conclusion
• References