Date of Award


Document Type


Degree Name

Master of Public Health


Health Science and Human Ecology

First Reader/Committee Chair

Harding, Kassandra


Background The coexistence of obesity and iron deficiency among children is one manifestation of the double burden of malnutrition (DBM) and is a public health concern. This study aims to provide useful insight on public health knowledge by presenting a current snapshot of the coexistence of obesity and iron deficiency among pre-school aged children as well as specific risk factors.

Methods This analysis utilizes secondary data from a publicly accessible, national database, the National Health and Nutritional Examination Survey (NHANES). The data examined were retrieved from the years 2015-2016 and 2017-2018. Chi-squared tests were used to test each thesis question.

Results Weight status was not found to be a statistically significant risk factor for iron deficiency. Among the complete study sample, the overall prevalence of DBM is 1.25%. In examining younger age, female, and race/ethnicity (Hispanic or Black) as risk factors for the DBM, none were statistically significant in this analysis. In examining household income below the poverty level and caregiver education at or below a high school degree as risk factors for DBM, neither were statistically significant. In examining food insecurity as a risk factor for iron deficiency and for overweight/obesity, I found food insecurity was not statistically significantly associated with iron deficiency but was associated with overweight/obesity (OR (95% CI): 1.57 (1.12, 2.20)).

Conclusion This analysis examined the prevalence of iron deficiency and overweight/obesity among children 1 – 5 years old in the United States. The literature and analysis suggest that children who experience overweight/obesity should be screened for iron deficiency. This is a pressing public health concern as iron deficiency and overweight/obesity are linked to short-term and long-term health consequences. Overweight/obesity is linked to chronic illness while iron deficiency is linked to cognitive and behavioral delays. More research on this double burden of malnutrition, and environmental and household risk factors are needed and welcomed. The additional research can provide valuable information to programs such as Head Start. This analysis also serves as a foundation for future studies and Head Start professionals in the United States to focus on the double burden of malnutrition.