Hunger is associated with poor health among low-income children in the United States, conclude nutritionists from Cornell University and the University of Michigan in the first national study to determine if the level of food deprivation that occurs in the U.S. is severe enough to affect children's health.

Specifically, the authors find that preschool and school-age children whose families sometimes or often go hungry are up to three times more likely to have reported poorer health and to have more stomachaches and headaches than children in well-fed families. Preschool-aged children who do not get enough food to eat also have more frequent colds.

"This study confirms that our social safety net has child-sized holes," says Katherine Alaimo, the first author on the study, who earned her Ph.D. at Cornell last year and is now a community health scholar at the University of Michigan. "The study underscores the urgency for achieving the objective set out in the federal government's Healthy People 2010 report that more families be food secure within the decade."

The research is an analysis of a nationally representative sample from the third (1988-1994) National Health and Nutrition Examination Survey (NHANES III) and was part of Alaimo's doctoral thesis research. Published in the American Journal of Public Health (May 2001), the study was conducted with Christine M. Olson and Edward A. Frongillo, Jr., both in the Division of Nutritional Sciences at Cornell, and Ronnette R. Briefel of Mathematica Policy Research, Inc., who was with the National Center of Health Statistics, Washington's principal vital and health statistics agency, at the time of the study.

According to the health and nutritional survey, more than 15 percent of children from low-income families and about 2 percent of children from middle-income families don't always have enough to eat. The study showed that hunger has a strong effect on children's health over and above living in poverty and associated risks such as not having health insurance or a regular source of medical care. "At every income level, children whose families do not get enough food to eat have poorer health," says Alaimo.

Low income also is associated with poorer health, the study indicated. Both low-income preschoolers and school-age children have a higher prevalence of poor or fair health, stomachaches, a restricting impairment and iron-deficiency than high-income children.

"The findings that poverty and inadequate food are linked with poorer health status are particularly alarming in light of recent evidence that social inequalities in health persist into adulthood," says Olson, the Hazel E. Reed Human Ecology Extension Professor in Family Policy and a professor of nutritional sciences at Cornell. "Food security is a critical component of child health policy."

Recent welfare reform policies that move families to work might not enable low-income families to get enough food if the jobs they find don't pay enough. In 1998, the four co-authors reported that about 4 million children in the United States don't get enough to eat and that employment is no guarantee of being well-fed. They reported that more than one-half of the 10 million Americans who sometimes or often don't get enough food to eat are from families where at least one person has a job.

The research was supported, in part, by a training grant from the National Institutes of Health.