Conceptualizing and contextualizing food insecurity among Greenlandic children

Figures & data

Table I Percentage of children age 11, 13 and 15 years in Greenland, Denmark, Canada, the United States and Russia reporting to go to bed or to school hungry, because of lack of food in home (data from the International HBSC study)

%		Always (%)	Often (%)	Sometimes (%)	Never (%)
Greenland (n=1,082)	11 year olds	11.1	8.4	16.5	64.1
	13 year olds	5.8	7.4	18.0	68.8
	15 year olds	3.5	4.9	20.0	71.6
Denmark (n=3,990)	11 year olds	6.0	2.1	13.4	78.4
	13 year olds	4.0	1.6	13.6	86.7
	15 year olds	4.5	2.0	11.9	81.7
Canada (n=15,578)	11 year olds	1.1	3.1	26.1	69.6
	13 year olds	1.2	2.5	21.2	75.1
	15 year olds	1.3	3.3	19.6	75.8
US (n=6,170)	11 year olds	1.8	3.4	24.0	70.2
	13 year olds	1.4	3.6	21.2	73.9
	15 year olds	1.4	3.0	29.2	76.4
Russia (n=4,946)	11 year olds	3.6	4.9	13.1	78.4
	13 year olds	3.6	5.2	13.3	77.8
	15 year olds	2.8	5.4	13.3	78.5
Mean in all HBSC countries (n=208.203)	11 year olds	1.5	2.2	17.1	79.2
	13 year olds	1.2	2.1	15.2	81.5
	15 year olds	1.2	2.4	14.3	82.1

Table II Domains and associations to food insecurity in children in Arctic aboriginal and Western countries reported in the literature

	In Western children	In Inuit and Indigenous children in the Arctic
Dietary consumption and nutritional outcomes	Consume fewer servings of fruits and vegetables (9) Consume fewer milk products Nutrient inadequacy for protein, micro-nutrients (vitamins, magnesium, phosphorous, and zinc) (7, 9, 33) Iron-deficiency anaemia (7) Overweight/obesity (conflicting evidence) (9, 42) Under nutrition or underweight for age and height (7, 9) Stunting (7, 9) Breastfeeding seem to give some protection (7) Report eating crisps, fried potatoes and hamburgers more often (schoolchildren) (35) Less likely to report eating breakfast on schooldays (schoolchildren) (37)	Lower median Healthy Eating Index (21) Consumed a lower mean number of different food items in the past day (21) Lower prevalence of any milk consumption (21) Higher median consumption of high-sugar drinks (21) Higher prevalence of traditional food consumption (preschool children) (21) Went hungry or skipping meals (20) High consumption of high-sugar foods and drinks in the household (23) Low consumption of grains, vegetables, fruits and milk in the household (23)
Physical health and development	Children having their health reported as “fair/poor” by parents (7, 9) Less children report excellent health (schoolchildren) (36, 37) Increased rates of acute and chronic illness (9) Predictor of chronic illness (preschool and schoolchildren) (7) Greater odds of hospitalization since birth (in toddlers) (7, 9) Low physical function (in 3–8 year-olds) (9) Being in developmental risk (infants and toddlers) (7) Parental developmental concern (9) Poor developmental trajectories (from kindergarten through 3rd grade) (9) More frequent stomach ache, head ache and colds (7, 9) More frequent report of physical symptoms (schoolchildren) (37) Lower IQ (partly explained by mothers personality and insensitivity to the children's needs) (8) Have been injured more often (schoolchildren) (37)	Less likely to have their health reported as excellent/very good (preschool children) (20) Less likely to be obese (23) Overweight/obese (29)
Life satisfaction and mental health	Increased risk of emotional problems (including higher levels of anxious and irritable, aggressive and oppositional behaviours) (schoolchildren) (9) Having increased anxiety (7) More likely to be aggressive (7) Having increased internalizing behaviour scores (7) Lower health related quality of life (9) Increased risk of having seen a psychologist (schoolchildren) Increased rate of depressive disorder and suicidal symptoms (in adolescents) (7) More likely to have clinical level of psychosocial dysfunction (6–12 year-olds) (7) Behavioural problems (partly explained by mothers personality and insensitivity to the children's needs) (8) More frequent report emotional symptoms (schoolchildren) (37) Less likely to report being happy with their lives (schoolchildren) (37)
Behavioural and psycho-social functioning	Lower psychosocial functioning (9) More likely to have seen a psychologist (7) Lower behavioural functioning (9) More difficulty with getting along with other children (teenagers) (7, 9)	Negative impact on psychological development (20)
	Having a decline in social skills (among boys) (7, 9) More often suspended from school (teenagers) (7, 9) More likely to have had dystonia/thoughts about death/attempted suicide (7) Higher level of hyperactivity, absenteeism and tardiness (7) Higher emotional stress (8) More likely to report poor communication with parents (schoolchildren) (34, 37)
Academic performance	More likely to have repeated a grade (7, 9) Receive lower arithmetic scores (7, 9) Impaired academic performance in reading and mathematics (9) Smaller increase in reading scores (7)	Negative impact academic performance (20)
Risk factors in the home environment	Stressful life events (7–9) Chronically ill parent (9) Recently divorced parent (9) A child with physical disability or injury, learning disability or physical disability (9) Medical care (no usual source of care, postponed care, postponed medications and not receiving the recommended well-child care visit) (with simultaneous housing instability) (9) Smoking in the household (9) Parental depression (especially maternal) (7–9) Parental practices, attachment and proficiency (toddlers) (9) Substance abuse Lower interviewer perceived household sensitivity to children's needs (8)	Substance abuse (19)
Health behaviour	More likely to report high level of television viewing (schoolchildren) (34, 37) More likely to have a history of drunkenness (schoolchildren) (34, 37) More likely to smoke (schoolchildren) (34, 37) More likely to have infrequent tooth-brushing (schoolchildren) (34, 37) Less likely to report to use seatbelt (schoolchildren) (34, 37)
Socio-demographic risk factors in the household	Poverty/low income in household (7–9, 27) Minority/immigrant status/indigenous (7, 9) Low level of educational achievement in parents Unemployment or low level of labour force participation Getting social assistance/income support (27) Lone parent family (7, 27) Household headed by a woman (7, 27) Public or rented housing (7) Multiple child household or crowding Households with young children (7) Living remote (29)	Aboriginals including Inuit (20, 27, 40) Poverty or be in the lowest income adequacy category (27, 40) Multichild households (3 or more) (40) Large families (19) Household crowding (21, 23) Having a home in need of major repairs (21, 23) Public housing (21, 23) Low levels of education achievement in parents (40) Reliance on social assistance and welfare (21, 40) Low level of labour force participation or income from sources other than wages or salaries (40) Households headed by lone parents (19) Families who have no active hunter (19, 23) Low cash-flow (19)
		Number of adults in the home showed tendencies for a protective effect (21) Lack of economic access (20)
Socio-demographic risk factors in the child	Age (schoolchildren) (36, 38) Gender (schoolchildren) (36, 38) Living remote (38)	Age (schoolchildren) (16) Gender (schoolchildren) (16) Living remote (schoolchildren) (16)

Table III Comparison between schoolchildren age 11–17 who “never” and “sometimes, often and always” experience to go to bed or to school hungry at central HBSC items on the 8 domains

Area	Item	Never	Sometimes, often or always	Chi^2
Dietary consumption and nutritional outcomes	Eating breakfast on all schooldays	64.7	52.9	p<0.001
	Eating fruit 5–6 times a week or more	29.4	23.9	p=0.02
	Drinking soft drinks 5–6 times a week or more	46.9	46.3	p=0.82
Physical health and development	Physical symptoms (headache, stomach ache or back ache) nearly every week	66.5	61.3	p=0.04
	Self-rated health “good” or “excellent”	83.7	77.0	p<0.001
Life satisfaction and mental health	Psychical symptoms (depressed, irritable or nervous) nearly every week	59.5	56.2	p=0.21
	Very best quality of life	33.6	28.0	p=0.02
Behavioural and psycho-social functioning	Never bullied	64.2	56.7	p=0.002
	Never bullied others	59.5	50.7	p<0.001
	Feel accepted by classmates	71.1	74.2	p=0.19
Academic performance	Good or very good academic achievement	71.5	62.9	p<0.001
	Not pressured by schoolwork	40.7	31.9	p<0.001
Risk factors in the home environment	Difficult to talk to mother about something that really bother	60.2	52.6	p=0.003
	Difficult to talk to father about something that really bother	43.0	42.5	p=0.83
	Eating dinner with parents every day	75.5	67.9	p=0.001
Health behaviours	Tooth brushing twice a day	65.7	50.6	p<0.001
	Daily smoking	24.8	28.1	p=0.13
	Been drunk more than once	22.2	20.9	p=0.52
Socio-demographic risk factors	Age (see Table I)
	Gender, boys/girls experienced hunger	62.3/73.5	37.7/26.5	p<0.001
	Low family affluence	34.0	47.3	p<0.001
	Living in a settlement	18.4	28.4	p<0.001

Kursmark M, Weitzman M. Recent findings concerning childhood food insecurity. Curr Opin Clin Nutr Metab Care. 2009; 12: 310–16.

 PubMed Web of Science ®Google Scholar

Cook JT, Frank DA. Food security, poverty, and human development in the United States. Ann N Y Acad Sci. 2008; 1136: 193–209.

 PubMed Web of Science ®Google Scholar

Holmes B. The influence of food security and other social and environmental factors on diet in the National Low Income Diet and Nutrition Survey. Proc Nutr Soc. 2008; 67: E88.

 Google Scholar

Eisenmann JC, Gundersen C, Lohman BJ, Garasky S, Stewart SD. Is food insecurity related to overweight and obesity in children and adolescents? A summary of studies, 1995–2009. Obes Rev. 2011; 12: e73–83.

 PubMed Web of Science ®Google Scholar

Molcho M, Gabhainn SN, Kelly C, Friel S, Kelleher C. Food poverty and health among schoolchildren in Ireland: findings from the Health Behaviour in School-aged Children (HBSC) study. Public Health Nutr. 2007; 10: 364–70.

 PubMed Web of Science ®Google Scholar

Doyle P, Gavin A. The HBSC Ireland Team. Fact sheet. Food poverty among schoolchildren in Ireland. 2006; Galway: Health Promotion Research Centre, National University of Ireland. 1–2.

 Google Scholar

Egeland GM, Williamson-Bathory L, Johnson-Down L, Sobol I. Traditional food and monetary access to market-food: correlates of food insecurity among Inuit preschoolers. Int J Circumpolar Health. 2011; 70: 373–83.

 PubMed Web of Science ®Google Scholar

Egeland G, Pacey A, Cao Z, Sobol I. Food insecurity among Inuit preschoolers: Nunavut Inuit child health survey, 2007–2008. CMAJ. 2010; 182: 243–8.

 Web of Science ®Google Scholar

Huet C, Rosol R, Egeland GM. The prevalence of food insecurity is high and the diet quality poor in Inuit communities. J Nutr. 2012; 142: 541–7.

 PubMed Web of Science ®Google Scholar

Kelly C, Gavin A, Molcho M, Gabhainn SN. The Irish Health Behaviour in School-aged Children (HBSC) study 2010. 2012; Galway: Health Promotion Research Centre, National University of Ireland. 1–64.

 Google Scholar

Belsky DW, Moffitt TE, Arseneault L, Melchior M, Caspi A. Context and sequelae of food insecurity in children's development. Am J Epidemiol. 2010; 172: 809–18.

 Web of Science ®Google Scholar

Fergurson H. Inuit food (In)security in Canada: assessing the implications and effectiveness of policy. Queens Policy Rev. 2011; 2: 54–79.

 Google Scholar

Levin KA, Currie C. Adolescent toothbrushing and the home environment: sociodemographic factors, family relationships and mealtime routines and disorganisation. Community Dent Oral Epidemiol. 2010; 38: 10–8.

 PubMed Web of Science ®Google Scholar

Chan HM, Fedliuk K, Hamilton S, Rostas L, Caughey A, Kuhnlein H, etal. Food security in Nunavut, Canada: barriers and recommendations. Int J Circumpolar Health. 2006; 65: 416–31.

 PubMed Web of Science ®Google Scholar

Che J, Chen J. Food insecurity in Canadian households. 2001; Ottawa: Statistics Canada. 11–22.

 Google Scholar

Willows ND, Veugelers P, Raine K, Kuhle S. Prevalence and sociodemographic risk factors related to household food security in Aboriginal peoples in Canada. Public Health Nutr. 2008; 12: 1150–6.

 PubMed Web of Science ®Google Scholar

Freeman JG, Saab H, King M, Gropp K. Health and health-related behaviours among young people in Yukon. 2011; Yukon Government. 1–103.

 Google Scholar

Hansen JC, Deutch B, Odland JØ Dietary transition and contaminants in the Arctic: emphasis on Greenland. 2008; Oulu: International Association of Circumpolar Health. 1–96.

 Google Scholar