<p>Crude and adjusted odds ratios.</p>

Food insecurity, characterized by uncertain or limited access to adequate food, remains a pressing public health issue. South Africa, particularly its rural areas, continues to experience significant levels of food insecurity, exacerbated by economic inequality and structural barriers. This study aimed to investigate how the demographics of the household head, household crowding, and wealth influence household food security in rural Limpopo Province, South Africa. A cross-sectional study was conducted using routinely collected data from the DIMAMO Health and Demographic Surveillance System, including 17,374 household heads in rural Limpopo Province. Data was analyzed using STATA 16.1. Both bivariable and multivariable regression reported that an increase in the household head’s age was negatively associated with food insecurity. Similarly, household heads in the middle category of the wealth index were protective of food insecurity (OR=0.73; 95%CI:0.59-0.90). In binary logistic regression, household crowding was associated with food insecurity (OR= 2.03; 95%CI: 1.65-2.49). Similar results were noted in multivariable regression, even after adjusting for possible confounders (AOR = 2.62; 95%CI: 1.75-3.90). Divorced household heads were also associated with food insecurity (AOR = 5.39; 95%CI:2.88-10.12). The age of the household head was reported to be a protective factor for food insecurity (AOR = 0.17;95%CI:0.10-0.31), with food insecurity decreasing as age increased. The present study noted a low prevalence of food insecurity (3.51%). The low prevalence of food insecurity suggests that social protection mechanisms and local indigenous farming are a crucial barrier to households’ food scarcity. Household food insecurity in rural Limpopo is influenced by household head age, household crowding, marital status, and wealth, rather than gender, education, or employment status. These findings highlight the need for targeted policy responses, including the extension of income-support mechanisms to unemployed younger household heads, focused social support for widowed households, and community-based interventions aimed at reducing the economic strain associated with household crowding.