Household Food Insecurity and Childhood Undernutrition Among Residents of Low-cost Public Housing: A Cross-sectional Study in Malaysia

Urbanization in Malaysia has led to an increase in the number of low-income households vulnerable to food insecurity. This study investigates the prevalence of household food insecurity (HFIS) and its association with childhood undernutrition among low-income families in Klang Valley, Malaysia. A cross-sectional study was conducted from November 2022 to July 2023 among 275 households with children aged 6–59 months. Household food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS), and nutritional outcomes—stunting, underweight, and wasting—were measured using WHO standards. Multivariate logistic regression was used to identify factors associated with HFIS and its link to undernutrition. Over half (57.1%) of the surveyed households experienced food insecurity. The prevalence of undernutrition was 36.4% for stunting, 20.6% for underweight, and 15.7% for wasting. Households with income below the poverty line (RM2208/month, ~USD470/month) were more likely to experience HFIS (adjusted odds ratio, aOR 2.09, 95% CI: 1.19–3.68, p<0.01). HFIS significantly increased the odds of stunting (aOR 1.75, 95% CI: 1.01–3.04, p<0.05), but associations with underweight and wasting were not statistically significant. The study highlights the major issue of food insecurity among urban low-income families and its significant role in childhood stunting. Targeted public health interventions addressing poverty and food insecurity are essential to curb undernutrition in urban areas.