Heat or Eat: The Low Income Home Energy Assistance Program and Nutritional and Health Risks Among Children Less Than 3 Years of Age

Abstract

Even within a low-income renter sample, Low Income Home Energy Assistance Program benefits seem to reach families at the highest social and medical risk with more food insecurity and higher rates of low birth-weight children. Nevertheless, after adjustment for differences in background risk, living in a household receiving the Low Income Home Energy Assistance Program is associated with less anthropometric evidence of undernutrition, no evidence of increased overweight, and lower odds of acute hospitalization from an emergency department visit among young children in low-income renter households compared with children in comparable households not receiving the Low Income Home Energy Assistance Program. The Low Income Home Energy Assistance Program in many states shuts down early each winter when their funding is exhausted. From a clinical perspective, pediatric health providers caring for children from impoverished families should consider encouraging families of these children to apply for the Low Income Home Energy Assistance Program early in the season before funding is depleted. From a public policy perspective, although this cross-sectional study design can only demonstrate associations and not causation, these findings suggest that, particularly as fuel costs and children's poverty rates increase, expanding the Low Income Home Energy Assistance Program funding and meeting the national Low Income Home Energy Assistance Program performance goal of increasing the percentage of recipient households with young children might potentially benefit such children's growth and health.

Medical-Legal Strategies to Improve Infant Health Care: A Randomized Trial

“…5,6 Poverty affects children both directly, when material needs are not met, and indirectly, through amplifying family stress. Children's health suffers when basic needs such as food, [7][8][9][10][11][12] housing, 13,14 and utilities 15,16 are not met. Adverse impacts include low weight for age, developmental concerns and behavioral problems, higher risk of hospitalization, and overall poor health as rated by parents.…”

Is Maternal Food Security a Predictor of Food and Drink Intake Among Toddlers in Oregon?

“…As the extent of food insecurity has become better understood, some researchers have sought to identify contextual factors at the stateand county-level that influence the likelihood that families will experience food insecurity, such as housing affordability [7,8]. Other researchers have sought to investigate the role of food insecurity in the development of adverse mental, physical, and behavioral health outcomes in childhood, such as internalizing and externalizing problems, iron deficiency anemia, and increased hospitalization [9][10][11][12][13][14][15][16]. Even so, opportunities for intervention remain elusive, in part because of a lack of clarity over the pathways linking food insecurity to healthy mental, physical, and behavioral development.…”

Addressing Social Determinants of Health at Well Child Care Visits: A Cluster RCT

“…Research has confirmed this finding with recent studies demonstrating that poverty, and the unmet basic needs that result from it, results in greater susceptibility to disease and poorer health across the life span. [3][4][5][6]23,[28][29][30][31][32][33][34][36][37][38] Despite numerous leaders in the field advocating for addressing social needs as part of primary care [9][10][11][12]39 and professional guidelines emphasizing the need to address social determinants, [13][14][15][16][17] there has been little evidence to help guide this practice. 27,40 A previous study by our group demonstrated that a similar system can lead to more discussion and referrals for family psychosocial problems by pediatric trainees.…”

“…We decided to screen for these needs because of their high prevalence among urban families, 19,27 the public availability of community resources designed to address them, and previous research demonstrating the association of these needs with negative child outcomes. 23,[28][29][30][31][32][33][34] The WE CARE clinical screening instrument was adapted from a larger family psychosocial screening instrument with test-retest reliability of .92. 19 For the current study, the survey consisted of 12 questions designed to identify the 6 basic needs and determine whether mothers wanted assistance with each need (Supplemental Appendix).…”