A mixed-methods investigation of race, income, food insecurity and maternal and infant health

Bibliographic Data

ID15095151
AuthorsMadison S Dickey (0000-0002-0101-2922, Pennington Biomedical Research Center), Kelsey O Goynes (Pennington Biomedical Research Center), Chelsea L Kracht (0000-0002-5467-0849, Pennington Biomedical Research Center), Briasha Jones (Woman's Hospital), Emerson Simeon (Pennington Biomedical Research Center), Jada Butler (Pennington Biomedical Research Center), Maryam Kebbe (0000-0001-7999-9299, Pennington Biomedical Research Center), Yun Shen (0000-0002-7651-4265, Pennington Biomedical Research Center), Gang Hu (0000-0002-7892-5578, Pennington Biomedical Research Center), Emily W Harville (0000-0003-0319-0922, Tulane University), Elizabeth F Sutton (0000-0002-8807-6434, Woman's Hospital), Leanne M Redman (0000-0002-7267-7374, Pennington Biomedical Research Center), Leanne Redman (Pennington Biomedical Research Center, corresponding author)
Year2026
Volume29
Issue1
Pagese36-e36
Publication date2026-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980026101955
PMID41623093
OpenAlexW7127097079
LanguageEN

Objective: To examine how race, income and food insecurity (FI) interact during pregnancy and whether FI contributes to disparities in maternal and infant health outcomes. Design: Observational cohort study employed sequential explanatory a mixed-methods design, with a survey phase (including Household Food Security Survey Module [HFSSM] six-item) and medical record abstraction followed by semi-structured interviews. Setting: Online survey, virtual interviews. Participants: The participants were individuals who gave birth in Louisiana, USA, between June 2020 and June 2021. The quantitative phase comprised 1691 individuals who completed the survey. A nested cohort of forty individuals (evenly split by race (Black v. White) and income (low v. high)) subsequently completed semi-structured interviews. Results: Race and income were independently associated with both FI and maternal and infant health outcomes. When considering both income and FI, low-income individuals with FI were 1·73 times more likely to deliver low birthweight (LBW) infants (adjusted Odds Ratio [aOR] 95 % CI: 1·07, 2·82) and 1·43 times more likely to experience adverse infant outcomes (aOR 95 % CI: 1·02, 2·00) than high-income individuals without FI. Black individuals with FI were 2·49 times more likely to deliver LBW infants (aOR 95 % CI: 1·45, 4·29) than White individuals without FI. Interview findings revealed low-income individuals faced disproportionate barriers to accessing healthy food and making dietary choices, which were further complicated by pregnancy-related conditions. Conclusions: The interplay between race, income and FI significantly increases the risk of adverse infant health outcomes, demonstrating a synergistic effect. Targeted efforts to address FI, particularly among low-income pregnant individuals, are essential to improving maternal and infant health outcomes

Adverse Childhood Experiences · Child health · Food insecurity · Infant mortality · Low income · Maternal health · Pregnancy · Public health · Breastfeeding Practices and Influences · Food Security and Health in Diverse Populations · Homelessness and Social Issues