Food insecurity among waste-picking children in Iran and its associated factors.

Waste-picking children represent one of the most marginalized groups in urban settings, facing poverty, poor health, and food insecurity. This study investigated the prevalence of food insecurity and its determinants among waste-picking children in Tehran. A cross-sectional survey was conducted among children aged 13-18 years in different districts of the city during autumn and winter 2024. Participants were selected through multi-stage sampling and assessment using a socio-demographic questionnaire and the Household Food Insecurity Access Scale. Logistic regression was applied to explore factors associated with severe food insecurity. Findings revealed that only 26.9% of children were food secure, while 11.3% experienced mild, 38.4% moderate, and 23.5% severe food insecurity. Living with family and being of Iranian ethnicity emerged as protective factors, while low household income, poor self-reported health, smoking, and oral or dental problems significantly increased the likelihood of severe food insecurity. These results highlight the urgent need for interventions that address structural and social vulnerabilities. Ensuring access to healthcare and nutrition programs, supporting families through social protection, and reducing inequalities are critical steps to improve food security in this population. Focused policies and community-based programs can help protect waste-picking children from long-term adverse outcomes linked to chronic deprivation.