An article published in the October 2008 edition of the journal Pediatrics finds that infants and toddlers are more likely to experience food insecurity, negative health hospitalizations, and developmental risks if they reside in households with increasing energy insecurities. The Boston Medical Center (BMC) researchers consider a household to be experiencing energy insecurity if it does not have consistent access to the amount or the kind of energy that is required to live healthfully and safely.

As energy prices rise, many low-income families have to face significant tradeoffs; often they must choose between paying utility bills and paying for food, rent, and other necessities. Previous research has shown how inadequate home heating and cooling can affect the elderly, but there is little research that addresses the health and developmental effects of home energy insecurity on infants and toddlers.

To further investigate this topic, the BMC researchers conducted a cross-sectional study of 9,721 children and their caregivers. Data came from emergency departments and primary care clinics in five large urban hospitals. The investigators found that about 11% of the children (1,043 of 9,721) had experienced moderate energy insecurity, and 23% (2,293 children) experienced severe energy insecurity.

Compared to children in energy secure households, those exposed to moderate or severe energy insecurity have over one-third greater odds of their caretaker reporting them in fair or poor health. Further, the odds of being hospitalized since birth for a child from a moderately-insecure household were 22% greater compared to a child from an energy-secure home.

According to the researchers, a partial explanation for these poorer health outcomes could be driven by the difficult choices that families must make between paying for energy to heat (or cool) their homes and paying for adequate nutrition.

“In addition to direct effects of unregulated environmental temperatures on infant and child health, our data suggests that household food insecurity associated with energy insecurity can also adversely affect children’s nutritional status and health,” remarks author John Cook, PhD (Children’s Sentinel Nutrition Assessment Program (C-SNAP) at BMC).

He concludes that, “Pediatric health care providers need to be aware of the energy security status of their patients’ households and use this information to inform decisions regarding both treatment and referrals for other services.”

A Brief Indicator of Household Energy Security: Associations With Food Security, Child Health, and Child Development in US Infants and Toddlers
John T. Cook, PhD, Deborah A. Frank, MD, Patrick H. Casey, MD, Ruth Rose-Jacobs, PhD, Maureen M. Black, PhD, Mariana Chilton, PhD, MPH, Stephanie Ettinger de Cuba, MPH, Danielle Appugliese, MPH, Sharon Coleman, MS, MPH, Timothy Heeren, PhD, Carol Berkowitz, MD and Diana B. Cutts, MD
PEDIATRICS 122[4]: e867-e875.
doi:10.1542/peds.2008-0286
Click here to view journal website

Written by: Peter M Crosta