Poverty, food insecurity and nutritional deprivation in rural China: Implications for children's literacy achievement

Abstract

Globally, food insecurity is a significant contextual aspect of childhood. About 850 million people were undernourished worldwide during the period 2006–2008, including 129.6 million people, or 10 percent of the population, in China (FAO, 2011, pp. 45–46). Implications of food insecurity for children's schooling in developing country contexts are poorly understood. Analyses of a survey of children from 100 villages in northwest China show that long-term undernourishment and food insecurity strike the poorest disproportionately, but not exclusively; long-term undernourishment matters for literacy via early achievement; and, after adjusting for socioeconomic status, long-term undernourishment, and prior achievement, food insecure children have significantly lower literacy scores.

Introduction

According to guidelines developed by an expert working group of the American Institute of Nutrition (Cook and Frank, 2008, p. 193), food insecurity is defined as “Limited or uncertain availability of nutritionally adequate and safe foods, or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.”¹ Evidence suggests that insecure access to nutritious food remains a significant global problem. According to the Food and Agriculture Organization's State of Food Insecurity in the World (2011, pp. 45–46), 850 million people were undernourished worldwide during the period 2006–2008, including 129.6 million people, or 10 percent of the national population, in China.

Food insecurity has been linked to a wide variety of adverse health and developmental outcomes in children and adults—both nutrition-related and non-nutrition related (Cook and Frank, 2008, American Dietetic Association, 2010). Food insecurity is associated with higher prevalence of inadequate intake of key nutrients (Rose et al., 1998, Casey et al., 2001, Lee and Frongillo, 2001a, Lee and Frongillo, 2001b, Lee and Frongillo, 2001c, Adams et al., 2003), risk of overweight status in women and some girls (Olson, 1999, Alaimo et al., 2001c, Laitinen et al., 2001, Townsend et al., 2001, Dinour et al., 2007; but see Kuku et al., 2012 for insignificant effects of food insecurity on children's overweight status in the US), depressive symptoms in adolescents (Alaimo et al., 2002), poorer interpersonal relations, less self control, and non-cognitive skills impairments and general academic difficulties and social developmental delays in children (Kleinman et al., 1998, Murphy et al., 1998, Alaimo et al., 2001a, Reid, 2000, Stormer and Harrison, 2003, Ashiabi, 2005, Howard, 2011, Roustit et al., 2010). Results from a longitudinal study of welfare recipients in the United States show that household food insecurity is associated with poor physical and mental health of low-income black and white women (Siefert et al., 2004). Food insecurity is also associated with more behavioral problems (Olson, 1999, Slack and Yoo, 2005), poorer school performance (Olson, 1999, Alaimo et al., 2001a, Dunifon and Kowaleski-Jones, 2003), and adverse health outcomes (Alaimo et al., 2001b, Cook et al., 2004, Weinreb et al., 2002) in children. Data from the Early Child Longitudinal Study-Kindergarten Class show that reporting at least one indicator of food insecurity was significantly associated with impaired learning in mathematics from fall to spring of the kindergarten year (Winicki and Jemison, 2003) and with impaired learning in reading from kindergarten to third grade (Jyoti et al., 2005). Belsky et al. (2010) characterize “material hardship related to food”—food insecurity, food insufficiency, and hunger—as a “reliable correlate of cognitive, behavioral, and emotional problems among low income children,” but note that many, though not all, of the disadvantages are explained by other features of household structure.

The knowledge that we have about the consequences of food insecurity for children's well-being is limited in a number of ways. Relatively few studies have employed longitudinal data (Winicki and Jemison, 2003, Jyoti et al., 2005). Most utilize data from developed countries, and most employ a fairly limited set of educational measurements. Focusing on the case of rural children in an impoverished province in western China, we address these limitations in this project. Our dataset includes household measures of food insecurity reported by mothers and measures of long-term nutrition status (measured anthropometry), as well as a purpose-designed literacy assessment administered to children. We combine these measures with detailed measures of socioeconomic status of households, a strategy that allows us a close look at links between food insecurity and poverty. Finally, we employ a longitudinal dataset that allows us to adjust for baseline school performance.

We begin with the descriptive task of establishing prevalence of food insecurity among children, and the relation of this issue to poverty and to measured anthropometry. Next, we address our main analytic question: whether food insecurity is linked to children's learning outcomes, measured by a literacy assessment, before and after adjusting for baseline school performance and long term nutrition (captured by anthropometry measures).