Food Security Impacts Health of Children With Orofacial Clefts: An 8-Year Review of the Global Burden of Disease Study

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Abstract
Objective: To determine if increased food security (FS) reduces mortality, prevalence, and disability in patients with orofacial clefts (OFCs). Design: Ecological study. Setting: A total of 204 countries and territories in the Global Burden of Disease Study and FS data from 113 countries from the Global Food Security Index. Patients, Participants: Deidentified country-level data on patients with OFCs <4 years old from years 2012 to 2019. Interventions: None. Main Outcome Measure: Number of deaths from OFCs, prevalence of OFCs, and disability adjusted life years (DALYs) from OFCs per 100,000 people. Results: Of 113 countries with data from 2012 to 2019, regression showed a 13.8% decreased rate of death (incidence rate ratio 0.862 [95% confidence interval (CI) 0.852, 0.871]) and 74.9% higher odds of nondeath (odds ratio 1.749 [95% CI 1.106, 2.786]) with a 1-point increase in FS score. A linear relationship was demonstrated between FS and prevalence of OFCs (β −18.5 [95% CI −34.8, −2.3]) and DALYs from OFCs (β −43.1 [95% CI −62.6, −23.5]) with a 1-point increase in FS score as well. The greatest reductions in mortality and DALYs were seen in children <1 year whereas reductions in prevalence were seen in children 2-4 years, attributed to decreases in late presentations. Conclusion: Our study shows higher FS is associated with reduced deaths from OFCs, prevalence of OFCs, and DALYs from OFCs. We hope our study validates efforts by nutritional programs led by OFC teams and provides evidence for further support.

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