Risk and Protective Factors Associated with Adolescent Food Insecurity in Baltimore
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Risk and Protective Factors Associated with Adolescent Food Insecurity in Baltimore Kristin Mmari Marshall
&
Anne Smith & Susan Gross & Beth
Accepted: 22 September 2020 # The New York Academy of Medicine 2020
Abstract While emerging evidence is highlighting a growing problem of food insecurity among adolescents in disadvantaged neighborhoods, very little is known about the factors that may either protect or place adolescents at higher risk for food insecurity. The primary objective for this analysis, therefore, was to examine the associations between individual-, family-, and neighborhood-level risks and protective factors and food insecurity among 452 adolescents in Baltimore, Maryland. Results show that nearly 30% of our sample were food insecure (29.4%). Food insecure youth were more likely to be unstably housed (OR 5.17, 1.24– 21.62), live in larger households (OR 1.14, 1.08–1.20), and perceive their neighborhoods unsafe (OR 2.37, 1.47–3.83). Protective factors included perceiving both male and female adult support (OR 0.55 and 0.47, respectively), having a higher sense of community belonging (OR 0.91, 0.32–0.95) and having positive perceptions of their neighborhood’s physical environment (OR 0.93, 0.88–0.98). These results suggest that strengthening family and neighborhood relations and resources may promote the health of adolescents in disadvantaged urban areas. Keywords Urban adolescents . Food insecurity . Neighborhood factors . Family factors K. Mmari (*) : A. Smith : S. Gross : B. Marshall Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA e-mail: [email protected]
Introduction Food insecurity, defined as limited or uncertain access to adequate food, is a widespread, but often hidden problem among adolescents in low-income neighborhoods in the USA [1–3]. Food insecurity among young people is particularly concerning, as adolescence is a critical developmental stage [4]. The onset of puberty to adulthood involves hormonal changes that stimulate structural and functional shifts in the adolescent brain [5]. During this period of immense change, proper nutrition and caloric intake are particularly important [6]. However, there is growing evidence that shows foodinsecure youth not only have poor nutrition and reduced levels of physical activity but are much more likely to have impaired cognitive development and mood, anxiety, and behavior disorders [7, 8]. Recent qualitative studies have also shown that food insecure adolescents often have to engage in high risk behaviors to mitigate the effects of food insecurity [1–3]. For example, in Baltimore, adolescent girls reported that it was easier for them to trade sex for money to purchase food than it was for them to visit food charity centers. For boys, it was common for them to sell drugs or shop lift to get money for food [1]. While the vast majority of research has examined food insecurity among parents and young children, very little research has been condu
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