(216) Patterns of Food Security and Iron Deficiency Anemia Among Black Pregnant Women

Objective:
Black pregnant people experience up to 5 times the risk of food insecurity when compared to other pregnant people. Among other social determinants of health and racism, food insecurity can lead to iron deficiency and iron deficiency anemia (IDA). Our study aimed to quantify nutrition knowledge, food security, and dietary behaviors among Black pregnant individuals and examine differences between those with and without IDA.

Study Design:
We conducted structured interviews with 30 Black pregnant and postpartum women aged ≥18 from 2024-2025, living in California or Texas. Participants self-reported IDA status, eligibility for the Women, Infants, and Children (WIC) program, and completed the United States Department of Agriculture’s Household Food Security Survey Module. Scores were categorized as food secure (≤1) or food insecure (2–6), stratified into low (2–4) and very low (5–6) security. Differences were assessed using Fisher’s exact test (p< 0.05).

Results:
Of 30 participants, 15 (50%) reported IDA, 15 (50%) were WIC-eligible, and 8 (27%) were both WIC-eligible with IDA (Table 1). Overall food insecurity was comparable between IDA (46.7%) and non-IDA (40.0%) groups. Very low food security was more common in IDA vs non-IDA participants, although the difference was not statistically significant (20.0% vs. 6.7%, p=0.76) (Figure 1). Food security was lower in WIC-eligible  participants. Comparing WIC-eligible vs. ineligible participants, 46.7% vs. 66.7% were food secure, 26.7% vs. 33.3% had low food security, and 26.7% vs. 0% had very low food security (p=0.13). WIC eligible participants with IDA were at the most risk for very low food security  (p=0.26).

Conclusion:
Very low food security was more frequent among participants with IDA,  WIC eligibility, or both. Though not statistically significant, this pattern highlights vulnerabilities potentially contributing to food insecurity. Our findings underscore the need for routine food insecurity screening in prenatal care and studies on culturally responsive interventions to reduce nutritional disparities among Black pregnant individuals.