Abstract

Background Children with congenital heart disease (CHD) require specialized care and may face worse outcomes if they experience food insecurity (FI). FI is associated with poor nutrition, hospitalizations, and developmental delays, compounding cardiac risks. Limited research evaluated impact of FI on health status among children with CHD. This study examines socioeconomic factors and the relationship between FI and health status in children with CHD.

Methods 2023 National Survey of Children’s Health (NSCH) data were used to compare rates of FI between children ages ≤ 17 years with and without CHD and to assess overall health status of those with CHD. Descriptive, univariate, and multivariable logistic regression were utilized.

Results Among 53,477 children, 1,233(2%) had CHD. FI was reported in 35% of children with CHD vs. 27% without CHD(p=0.005). After adjustment, children with CHD had higher odds of FI (OR 1.49; 95% CI: 1.05– 2.12). Hispanic ethnicity, residence in Midwest or South, lower household education, and lower poverty index were significantly associated with FI. Households receiving food assistance had higher FI. Living in grandparent household was associated with lower odds of FI. Within the CHD subgroup, 5% reported fair or poor health. Children with CHD experiencing FI had greater odds of fair or poor health than those without FI (OR 3.91, 95% CI 1.70–9.02; p=0.001).

Conclusions Children with CHD face higher odds of FI, which is strongly associated with worse reported health. Addressing socioeconomic vulnerability and FI may improve outcomes and reduce disparities in this high-risk population through targeted screening and intervention strategies nationwide.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

No funding received.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

IRB approval was obtained from the Institutional Review Board of the University of Texas at Austin.

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Yes

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Yes

Footnotes

IRB approval was obtained from the Institutional Review Board of the University of Texas at Austin.

Conflict of Interest Disclosures (includes financial disclosures): None

Funding: None

Presented at the 2025 National Conference and Exhibition of the American Academy of Pediatrics. The work was selected as a finalist for the Advocacy Abstract Award

Data Availability

NSCH data is publicly available.

AbbreviationsFIFood InsecurityCHDCongenital Heart DiseaseNSCHNational Survey of Children’s HealthAAPAmerican Academy of PediatricsSTROBEStrengthening the Reporting of Observational Studies in EpidemiologyFPLFederal Poverty LevelSNAPSupplemental Nutrition Assistance ProgramWICWomen, Infants, and ChildrenSSISupplemental Security IncomeOROdds RatioaORadjusted Odds RatioCIConfidence Interval