Date of Award

Fall 2025

Degree Type

Thesis

Department

Biological Sciences

Director of Thesis

Nicholas Younginer, Ph.D.

Second Reader

Leila Larson, Ph.D., MPH

Abstract

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional analysis of 5,494 children aged 5-17 years from the 2022 National Health Interview Survey (NHIS), and a landscape assessment of the Supplemental Nutrition Assistance Program (SNAP), the National School Lunch Program (NSLP) and School Breakfast Program (SBP), and SNAP-Education (SNAP-Ed). In the quantitative analysis, household food security was categorized in two ways: four USDA levels (high, marginal, low, very low) and a dichotomous measure (food secure vs. food insecure). Child outcomes were measured using the Strengths and Difficulties Questionnaire (SDQ), caregiver-reported neurodevelopmental diagnoses, and functional limitations measured by the Washington Group Child Functioning Module (CFM). Multivariate logistic regression models were adjusted for key demographic and contextual covariates.

Results: The literature indicates that food insecurity is consistently associated with internalizing and externalizing disorders, developmental delays, and poorer cognitive and academic outcomes, through pathways involving both nutritional deficits and chronic psychosocial stress. At the same time, studies reveal that protective factors such as social support, community-based initiatives, and resilience can promote optimal development. Quantitative findings show a clear dose- response relationship in which worsening household food insecurity is linked to significantly increased odds of SDQ difficulties, neurodevelopmental conditions, and functional impairment. Finally, the landscape assessment indicates that existing food assistance programs may improve diet quality, food security, and provide meaningful protection against the psychosocial consequences of food insecurity. However, their impact is limited by insufficient benefit amounts, coverage gaps, and environmental barriers that restrict opportunities for healthy eating.

Conclusions: The evidence presented here demonstrates a clear association between household food insecurity and a broad spectrum of adverse psychosocial and neurodevelopmental outcomes. Implications for policy and practice include raising SNAP benefits, universalizing school meals across the full day and year, pairing SNAP-Ed with structural purchasing incentives and community delivery, and incorporating validated measures of children’s psychosocial and mental health outcomes into routine program evaluations. These findings are relevant to current debates in public health, education, and social policy by translating evidence into actionable design changes that can improve immediate child well-being and mitigate long-term consequences.

First Page

1

Last Page

178

Rights

© 2025, Kayla A. Davenport

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