Diaper need is associated with risk for food insecurity in a statewide sample of WIC participants

Abstract

Diaper need is a form of material hardship that acutely affects families with young children, is not currently addressed by US antipoverty programs, and has received little public or scientific attention. This study examined the association between diaper need and risk for food insecurity in a statewide sample of participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Families enrolled in Vermont WIC in August 2019 were invited to an online survey. Generalized linear models were used to estimate the relationship between risk for food insecurity measured by the Hunger Vital Sign tool and diaper need, with and without adjustment for household factors. Follow-up questions asked those with diaper need what they do when they run out of diapers and those without diaper need how they access enough diapers. Complete data were available for 501 households. Over half (52.3%) were at risk for food insecurity and nearly one-third (32.5%) reported diaper need. The odds of experiencing risk for food insecurity were 3.852 (95% CI=2.557, 5.803) times greater for families with diaper need than for families that had enough diapers. The association persisted with adjustment for location, age of respondent, number of children in diapers, and length of time participating in WIC (adjusted OR=4.036, 95% CI=2.645, 6.160). Strategies to avoid running out of diapers included borrowing, stretching supplies, switching to cloth or underwear, and buying on credit. It is possible that public health interventions that address diaper need may reduce food insecurity in households with children.

Diaper Need During the COVID-19 Pandemic Associated with Poverty, Food Insecurity, and Chronic Illness: An Analysis of a Representative State Sample of Caretakers with Young Children

“…Aligning with the prepandemic research of Belarmino et al and supporting the in-depth qualitative work of Randles, 6 , 37 the findings of this study highlight the creative and difficult tradeoffs that those with diaper need make to access enough diapers. While most households without diaper need accessed enough diapers by purchasing them with their own money, households with diaper need utilized multiple inventive and time-intensive strategies to access diapers.…”

“…Aligning with prior research, we found diaper need to be higher among caregivers who were Latino, 5 had limited education, 5 were unemployed, 5 had mental health challenges, 3 , 24 or lived in low-income, 5 or food insecure households. 3 , 6 The associations between diaper need and income remained significant after adjustment.…”

“…However, the questions used for our primary outcome measure—diaper need—were developed with expert input and tested, and have been used previously. 3 , 6 , 24 …”

“…A multivariable logistic regression model, including significant covariates from bivariate analyses ( p <0.10) and those previously found to be associated with diaper need was used to examine the association between diaper need and demographic characteristics. 3 , 5 , 6 , 24 Education, household food security, and food assistance program participation were excluded from the model to reduce risk of collinearity.…”

“… 3 Most recently, a survey of families enrolled in Vermont's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) found that 32.5% of respondents reported diaper need. 6 …”