Intra- and intergenerational food insecurity: An analysis of Black and White women and children from the NHLBI Growth and Health Study.

Background: Food insecurity (FI) continues to be a significant public health concern and is associated with myriad physical and mental health consequences. Increased understanding of conditions around its occurrence throughout the life course are needed. However, research has been limited due to inadequate measurement tools and study length.

Objective: This study examined the intra- and intergenerational dynamics of FI over time by assessing the transmission of FI from childhood to adulthood, and from mother to offspring using population-specific FI measures, and the influence of sociodemographic factors.

Methods: Women in early midlife (n=624) and their children (n=331) participated in a prospective cohort study between 1987-2019 in Richmond, California. Three validated FI measures were assessed, representing 1) past childhood FI and 2) current adult household FI, reported by the women, and 3) current child FI, reported by the women's children. Associations between measures were examined using adjusted modified Poisson regression models. Mediation by current adult household FI between past childhood FI and their offspring's current child FI was assessed. Moderation by sociodemographic factors, including poverty level, parental education, marital status, and race was also assessed.

Results: Among women, 32.4% reported FI in childhood and 34.5% reported current adult household FI. Among their offspring, 53.2% reported current child FI. Past childhood FI increased the likelihood of current adult FI (RR: 2.18, 95%CI: 1.64, 2.90) and current adult FI increased the likelihood of current child FI (RR:1.49, 95%CI: 1.08, 2.07). Current adult FI partially mediated past childhood FI and their offspring's current child FI (Natural indirect effect: 1.42, 95%CI: 1.03, 2.24). There was no evidence of moderation by sociodemographic factors.

Conclusions: FI measures reported by adults and children capture differing experiences, highlighting the need to use FI measures that are appropriate for their target population. FI may be perpetuated intra- and intergenerationally.