Household food insecurity and preschool suspension/expulsion in the United States

Food insecurity is a serious public health concern, affecting approximately 15 million children in the U.S. alone. Exposure to household food insecurity has been linked to a host of deleterious outcomes among infants and children, including mental and behavioral health outcomes. Even so, scholars have yet to examine the connection between household food insecurity and early experiences of school punishment among preschool-aged children. The current study employs a nationally representative sample of 6100 preschool-aged children from the 2016 National Survey of Children's Health. Difference-of-means t-tests and multivariate logistic regression models examining the link between mild and moderate-to-severe household food insecurity and suspension/expulsion among preschool-aged children were conducted in 2020. All estimates were calculated using sample weights that adjust for nonresponse, probability of selection, and the demographic distribution of the target population (i.e., U.S. children attending preschool in 2016). The findings indicate a robust association between moderate-to-severe household food insecurity and suspension/expulsion among preschool-aged children. This association emerged only among male children, as their risk of suspension/expulsion increased more than 11-fold in the presence of moderate-to-severe food insecurity. Additional analyses revealed that a large portion of this association was attenuated upon accounting for parenting stress and child mental health. Trauma-informed nutrition assistance programming as well as early mental health assessment and consultation may yield collateral benefits in the form of reductions in preschool suspension/expulsion. Given the findings, moreover, future research should consider the role of household food insecurity in contributing to health inequities that perpetuate the school-to-prison pipeline.