{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T02:38:00Z","timestamp":1794278280601,"version":"4.9.0"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"unspecified","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1368980026101955_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine how race, income and food insecurity (FI) interact during pregnancy and whether FI contributes to disparities in maternal and infant health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101955_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101955_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Online survey, virtual interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101955_as4\">\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101955_as5\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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\u00b773 times more likely to deliver low birthweight (LBW) infants (adjusted Odds Ratio [aOR] 95 % CI: 1\u00b707, 2\u00b782) and 1\u00b743 times more likely to experience adverse infant outcomes (aOR 95 % CI: 1\u00b702, 2\u00b700) than high-income individuals without FI. Black individuals with FI were 2\u00b749 times more likely to deliver LBW infants (aOR 95 % CI: 1\u00b745, 4\u00b729) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101955_as6\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1368980026101955","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T09:57:01Z","timestamp":1770026221000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["A mixed-methods investigation of race, income, food insecurity and maternal and infant health"],"prefix":"10.1017","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-2922","authenticated-orcid":false,"given":"Madison S.","family":"Dickey","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey O.","family":"Goynes","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea L.","family":"Kracht","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"},{"name":"University of Kansas Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briasha","family":"Jones","sequence":"additional","affiliation":[{"name":"Woman\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emerson","family":"Simeon","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jada","family":"Butler","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7999-9299","authenticated-orcid":false,"given":"Maryam","family":"Kebbe","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"},{"name":"University of New Brunswick"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Shen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Hu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily W.","family":"Harville","sequence":"additional","affiliation":[{"name":"Tulane University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth F.","family":"Sutton","sequence":"additional","affiliation":[{"name":"Woman\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7267-7374","authenticated-orcid":false,"given":"Leanne M.","family":"Redman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040cnym54","id-type":"ROR","asserted-by":"publisher"}],"name":"Pennington Biomedical Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"S1368980026101955_ref12","doi-asserted-by":"publisher","DOI":"10.5888\/pcd13.160212"},{"key":"S1368980026101955_ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1087955"},{"key":"S1368980026101955_ref7","unstructured":"7. DeGruy, A , Teixeira, C , Evans, I et al. (2024) 2020 Louisiana Pregnancy-Associated Mortality Review Report. Maternal Mortality in Louisiana. Louisiana Department of Health. https:\/\/ldh.la.gov\/assets\/oph\/Center-PHCH\/FamilyHealth\/2020_PAMR_Report_April2024.pdf (accessed September 2024)."},{"key":"S1368980026101955_ref46","doi-asserted-by":"publisher","DOI":"10.1177\/0095399718764332"},{"key":"S1368980026101955_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s13668-022-00418-z"},{"key":"S1368980026101955_ref49","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0274434"},{"key":"S1368980026101955_ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.3189"},{"key":"S1368980026101955_ref35","doi-asserted-by":"publisher","DOI":"10.1097\/FCH.0000000000000183"},{"key":"S1368980026101955_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2024.114355"},{"key":"S1368980026101955_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2020.104685"},{"key":"S1368980026101955_ref29","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S1368980026101955_ref38","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13753"},{"key":"S1368980026101955_ref50","unstructured":"50. 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U.S. Department of Agriculture, Economic Research Service. https:\/\/ers.usda.gov\/sites\/default\/files\/_laserfiche\/publications\/104656\/ERR-309.pdf?v=85783 (accessed September 2024)."},{"key":"S1368980026101955_ref37","first-page":"438","article-title":"Food matters: food insecurity among pregnant adolescents and infant birth outcomes","volume":"6","author":"Grilo","year":"2015","journal-title":"J Appl Res Child"},{"key":"S1368980026101955_ref44","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2024.105205"},{"key":"S1368980026101955_ref14","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17207397"},{"key":"S1368980026101955_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523"},{"key":"S1368980026101955_ref31","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1865"},{"key":"S1368980026101955_ref48","doi-asserted-by":"publisher","DOI":"10.1177\/15248399211070546"},{"key":"S1368980026101955_ref41","doi-asserted-by":"publisher","DOI":"10.5455\/2394-6040.ijcmph20150211"},{"key":"S1368980026101955_ref43","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2024.1292071"},{"key":"S1368980026101955_ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.9043"},{"key":"S1368980026101955_ref20","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12884"},{"key":"S1368980026101955_ref4","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11030438"},{"key":"S1368980026101955_ref30","first-page":"1189","article-title":"Enhancing the quality and credibility of qualitative analysis","volume":"34","author":"Patton","year":"1999","journal-title":"Health Serv Res"},{"key":"S1368980026101955_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-020-00892-7"},{"key":"S1368980026101955_ref6","doi-asserted-by":"publisher","DOI":"10.1159\/000480536"},{"key":"S1368980026101955_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-023-03701-9"},{"key":"S1368980026101955_ref39","first-page":"2180","article-title":"Maternal food insecurity increases the risk of low birth weight babies: systematic review and meta-analysis","volume":"113","author":"de Freitas Rocha","year":"2024","journal-title":"Acta Paediatrica"},{"key":"S1368980026101955_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.113492"},{"key":"S1368980026101955_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14659"},{"key":"S1368980026101955_ref40","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzy003"},{"key":"S1368980026101955_ref47","doi-asserted-by":"publisher","DOI":"10.1177\/2752535X231214844"},{"key":"S1368980026101955_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.31277"},{"key":"S1368980026101955_ref19","doi-asserted-by":"publisher","DOI":"10.1097\/NMC.0000000000000895"},{"key":"S1368980026101955_ref21","unstructured":"21. 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Office of the Assistant Secretary for Planning and Evaluation. https:\/\/aspe.hhs.gov\/topics\/poverty-economic-mobility\/poverty-guidelines\/prior-hhs-poverty-guidelines-federal-register-references\/2020-poverty-guidelines\/2020-poverty-guidelines-computations (accessed October 2024)."},{"key":"S1368980026101955_ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-042753"},{"key":"S1368980026101955_ref45","doi-asserted-by":"publisher","DOI":"10.3390\/nu17020330"},{"key":"S1368980026101955_ref27","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2019-000774"},{"key":"S1368980026101955_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100378"}],"container-title":["Public Health Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1368980026101955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T07:17:51Z","timestamp":1784272671000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1368980026101955\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1368980026101955"],"URL":"https:\/\/doi.org\/10.1017\/s1368980026101955","relation":{},"ISSN":["1368-9800","1475-2727"],"issn-type":[{"value":"1368-9800","type":"print"},{"value":"1475-2727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e36"}}