Associations of social determinants of health and childhood obesity. A cross-sectional analysis of the 2021 National Survey of Children’s Health

Background: Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Children with low socioeconomic status (SES) have been shown to be overweight and have poor health outcomes. Therefore, our primary objective was to use the National Survey of Children’s Health (NSCH) 2021 data to determine current associations between childhood obesity and social determinants of health (SDOH).Methods: We conducted a cross-sectional analysis of 2021 NSCH to extract data from questions related to the SDOH domains. We extracted sociodemographic variables to use as controls and constructed bivariate and multivariable logistic regression models to determine associations, via odds ratios, between SDOH and child obesity.Results: Within the binary regression models, we found that children identified as having obesity were more likely than non-obese children to experience SDOH in all domains. After controlling for race/ethnicity, household income (%FPL), parental education, and child sex, children identified as having obesity were significantly more likely to experience food insecurity when compared to non-obese children (AOR = 1.39; 95% CI: 1.13-1.17).Conclusion: Our study found that the food insecurity domain of SDOH was significantly associated with childhood obesity. Improving policies for programs such as SNAP as well as addressing lack of access to nutritious foods, especially within food deserts, may help alleviate some food insecurity. Improving access to adequate amounts of nutritious foods is critical in addressing childhood obesity and thus, decreasing risk of chronic disease and poor long-term health outcomes

Association and disparities of food insecurity and child abuse: Analysis of the National Survey of Children’s Health

Background: Child abuse is a major public health issue and is a significant risk factor for compromised development, health morbidities, and the development of mental and behavioral disorders in children. Many factors contribute to child abuse, especially family stressors. Food insecurity, a significant family stressor, likely increases the rate of child abuse while also contributing directly and indirectly to the consequences on child development and lifespan. Given the adverse effects of child abuse and food insecurity, investigating their relationship is crucial to developing mitigation strategies.Purpose: Our primary objective was to assess the relationship between child abuse and food insecurity using data from the National Survey of Children’s Health (NSCH). Given that these disproportionately affect children of different demographic groups, our study aims to identify associations amongst varying demographic factors.Methods: We conducted an observational study assessing the National Survey of Children’s Health (2016-2021) to investigate the relationship between food security and child abuse. Using survey weights provided by the NSCH, we determined population estimates and rates of children experiencing food insecurity and child abuse. We then constructed logistic regression models to assess associations, via odds ratio, between food security groups and whether the child experienced child abuse. Finally, we constructed logistic regression models, via odds ratios, to assess food security and child abuse by demographic factors.Results: While rates of food security were similar across age groups, households with lower income had higher rates of marginal or low food security, as well as homes with Black, Indigenous, multi-racial, and Hispanic children. Compared to those with high food security, the odds of children with marginal or low food security were significantly more likely to experience child abuse (AORs: 2.36, 95% CI: 2.17-2.57 and 5.24, 95% CI: 4.59-6.00, respectively). Compared to White children with high food security, Indigenous, Black, and White children were significantly more likely to experience child abuse as household food security decreased.Conclusion: Child abuse and food insecurity have a significant association, including overlapping contributory factors and disparities. Efforts to improve food insecurity through policy, community food banks, and school-based programs may secondarily reduce child abuse. To address racial/ethnic disparities, the expansion of culturally-competent, evidence-based programs to reduce food insecurity should be established, which may also reduce risk factors for child abuse

ANTIVENOM OR OBSERVATION FOR PATIENTS WITH COPPERHEAD ENVENOMATION?

Retrospective cross-sectional review of treatment and outcomes in patients with crotawline snake bites