Adolescent-Reported Household Food Insecurity and Adolescents' Poor Mental and Physical Health and Food Insufficiency in Kenya

Measuring both adolescent- and adult-reported household food insecurity is important to understand household resources and needs, and the nonnutritional and nutritional outcomes for adolescents. Background Assessing adolescents' experiences of food insecurity in households is important for promoting healthy development. Although parental reports have been traditionally used, emerging research highlights the importance of child and adolescent reports of the household food environment. Objectives Extending research from high- and upper-middle-income countries, this study of adolescent compared with adult reports of household food insecurity in Kenya, a lower-middle-income country, examined 1) prevalence of and correspondence between adolescent and adult reports of household food insecurity, and 2) associations of adolescent and adult reports of household food insecurity with adolescent nonnutritional and nutritional outcomes. Methods Using data from the Kenya Violence Against Children Surveys (n = 1182), we assessed prevalence of household food insecurity reported by adolescents (ages 13-17 y) and adults, with McNemar chi(2) and kappa analysis of correspondence between reports. Ordinal and binary logistic regression assessed associations between adolescent and adult reports and adolescent mental health and self-rated physical health and food sufficiency outcomes. Results Household food insecurity was reported by 36% of adolescents and 63% of adults; 36% of adult reports were discordant with adolescent reports (kappa = 0.333). Odds of adolescent mental health difficulties were highest with adolescent-only report (OR = 2.11, P = 0.02), followed by adult and adolescent (OR = 1.83, P = 0.001) and adult-only (OR = 1.06, P = 0.77) report. Odds of poor adolescent self-rated physical health were highest with adult and adolescent report (OR = 2.47, P < 0.001) followed by adolescent-only (OR = 2.04, P = 0.08) and adult-only (OR = 1.37, P = 0.20) report. Odds of adolescents eating <= 1 meals the previous day were highest with adult and adolescent (OR = 21.38, P < 0.001) followed by adult-only (OR = 7.44, P = 0.01) and adolescent-only (OR = 2.31, P = 0.34) report. Conclusions Measuring household food insecurity with both adolescent report and adult report is important for having a comprehensive understanding of household resources and needs and of the nonnutritional (mental and physical health) and nutritional (diet and food) outcomes of household food insecurity for adolescents.