Article

Food Insecurity and Family Well-Being Outcomes among Households with Young Children

May 2018
The Journal of Pediatrics 196:275-282

DOI:10.1016/j.jpeds.2018.01.026

Authors:

Anna D Johnson

Georgetown University

Anna J. Markowitz

University of California, Los Angeles

Objectives: To investigate associations between household food insecurity and multiple family well-being variables in an effort to illuminate previously understudied, policy-amenable mechanisms through which food insecurity threatens healthy development. Study design: Data are drawn from the nationally representative Early Childhood Longitudinal Study-Birth Cohort. The Early Childhood Longitudinal Study-Birth Cohort contains longitudinal data on household food insecurity and several family well-being factors including maternal physical and mental health, positive parenting practices and disciplinary strategies, and frequency and severity of spousal conflict. We use regression models with lagged dependent variables to estimate associations between food insecurity and family well-being outcomes, on a subsample of low-income families (N ≈ 2100-4700). Results: Household food insecurity was significantly associated with poorer maternal physical health; increased depressive symptoms and use of harsh discipline strategies; and greater frequency and negativity of conflict between parents. Associations were strongest and most consistent when children were preschool aged. Transitions into food insecurity between toddlerhood and preschool were also associated with significantly worse parental physical and mental health outcomes, and more family conflict, with similar though slightly weaker and less consistent associations for transitioning into food insecurity between infancy and toddlerhood. Conclusions: Food insecurity is associated with significant decreases in family health and well-being. Clinicians and other public health officials play a critical role in assessing risk for children and families, and linking families with supportive services. Screening families experiencing or at risk for food insecurity and connecting them with resources is an avenue through which public health practitioners can support family health.

THE IMPACT OF NON-FARM BUSINESSES ON HOUSEHOLD FOOD SECURITY AND NUTRITION IN MALAWI MSc. (AGRICULTURAL AND APPLIED ECONOMICS) THESIS

Preprint

Full-text available

Jan 2025

Ian Yohane

Food insecurity is a pressing concern in Malawi, impacting around 5.4 million rural households. In recent years, non-farm businesses have become an increasingly important source of income and employment in Malawi, particularly in rural areas where agriculture is the dominant sector. These businesses can provide a valuable source of supplementary income for smallholder farmers. Thus, the main objective of the study was to assess the impact of non-farm businesses contribution to household food security and nutrition in Malawi and identify the factors influencing their impact. Using propensity score matching (PSM), on secondary data from Malawi's National Statistical Office (NSO). The study followed a two-stage approach, employing probit and multiple linear regression models to analyze determinants of non-farm businesses, food security, and nutrition. The factors that influence household food security positively include gender, household head's age, loan access, household size, and education on food security, while factors like region, marital status, extension access, and plot size can affect food security negatively. On the other hand, probit model revealed factors that affects nutrition namely household size, market access, and yield. Moreover, the adoption of non-farm businesses was affected by the household head's gender, education, extension access, region, and household size, while factors such as age, loan access, marital status, and plot size inhibit adoption. The PSM model demonstrated a positive average treatment effect of non-farm businesses on household food security and nutrition showing that non-farm businesses improve household food security and nutrition. Therefore, the study recommends (1) promoting gender equality, (2) enhancing access to credit, (3) region-tailored interventions, (4) education enhancement, (5) improved market access.

Association of household food insecurity with developmental delay in preschool children: 2018 Ecuadorian Nutrition and Health National Survey

Article

Full-text available

Aug 2023

We investigated the association of household food insecurity (HFI) with developmental delays in 36–59-month-old preschool children ( n 7005) using cross-sectional data from the 2018 Ecuadorian National Health and Nutrition Survey. HFI was assessed with the Food Insecurity Experience Scale and developmental delays with the Early Childhood Development Index. Log-binomial regression models estimated the association of HFI with global (overall) developmental delay (GDD) and delays in four individual developmental domains, adjusting for covariates. Nearly half of the children lived in households with marginal (24⋅5 %) or moderate-severe HFI (21⋅7 %). Eighteen percent were identified with GDD. Delays in the individual domains of literacy-numeracy, social-emotional, physical and cognitive development were identified for 64, 21⋅5, 3⋅3 and 3⋅1 %, respectively. GDD was more likely among preschool children from households with marginal (aPR = 1⋅29; 95 % C.I. = 1⋅10, 1⋅49) and moderate-severe HFI (aPR = 1⋅30; 95 % C.I. = 1⋅11, 1⋅51). Social-emotional development delays were also more likely among those from households with marginal (aPR = 1⋅36; 95 % C.I. = 1⋅19, 1⋅56) and moderate-severe HFI (aPR = 1⋅33; 95 % C.I. = 1⋅15, 1⋅54) different from the other three domains. Several other potentially modifiable risk (violent discipline, maternal depressive symptoms) and protective factors (adequate child stimulation, higher maternal education, handwashing with soap/detergent) were also independently associated with GDD and/or literacy-numeracy and cognitive delays. Our findings suggest that HFI is an independent risk factor for GDD and social-emotional developmental delays in Ecuadorian preschoolers. They underscore the importance of strengthening and expanding poverty reduction, food security and early childhood development policies and interventions to improve the opportunities for children to achieve their full developmental potential.

Understanding patterns of food insecurity and family well‐being amid the COVID‐19 pandemic using daily surveys

Article

Aug 2021

This paper investigates economic and psychological hardship during the COVID‐19 pandemic among a diverse sample (61% Latinx; 16% White; 9% Black; 14% mixed/other race) of socioeconomically disadvantaged parents (90% mothers; mean age = 35 years) and their elementary school‐aged children (ages 4–11; 49% female) in rural Pennsylvania (N = 272). Families participating in a local food assistance program reported on food insecurity (FI) and parent and child mood and behavior daily from January to May 2020. Longitudinal models revealed that FI, negative parent and child mood, and child misbehavior significantly increased when schools closed; only FI and parent depression later decreased. FI decreased most among those who received the local food assistance program; Supplemental Nutrition Assistance Program receipt uniquely predicted decreases in child FI.

Use of Food Distribution Resources among Military Families with Young Children Since the COVID-19 Pandemic

Article

Full-text available

Aug 2023
PUBLIC HEALTH NUTR

Objective: The present study examined military families' use of food distribution resources and military (e.g., rank) and non-military (e.g., race/ethnicity) characteristics associated with using food distribution resources. Design: Secondary data analyses from a cross-sectional survey in the first six months of 2021. Setting: A national sample of eligible families completed an online survey. Participants: 8,326 enlisted military families with an active duty service member in the Army or Air Force who applied for supplemental childcare funding distributed by National Military Family Association. Results: 13.2% of the families reported utilizing a food distribution resource in the past 12 months. Those with lower financial well-being were more likely to utilize such resources. Older (OR=1.04, 95% CI=1.02, 1.05, p<.001), single-earner (OR=.73, 95% CI=.61, .89, p=.001) families with a lower rank (OR=.69, 95% CI=.64, .75, p<.001) and Army affiliation (compared to Air Force) (OR=2.31, 95% CI=2.01, 2.67, p < .001) were more likely to utilize food distribution resources. Members of certain racial/ethnic minority groups were more likely to utilize food distribution resources than White respondents (OR from 1.47 for Multi-racial to 1.69 for Asians), as were families with more dependent children (OR=1.35, 95% CI=1.25, 1.47, p<.001). Conclusions: These results identify the extent of food distribution resource utilization in military families with young children approximately one year into the COVID-19 pandemic. The results also identify characteristics associated with their use of food distribution resources. Findings are discussed with an emphasis on prevention and intervention implications for military families.

Financial Inclusion and Food Insecurity: Examining Linkages and Potential Pathways

Article

Full-text available

Jan 2023
J CONSUM AFF

Considering the worsening levels of food insecurity globally, studies exploring the link between financial inclusion and food insecurity have become imperative. This paper contributes to the literature by examining the effect of financial inclusion on food insecurity using a multidimensional index of financial inclusion and a food insecurity construct obtained from the Food Insecurity Experience Scale. Based on data extracted from the seventh round of the Ghana Living Standards Survey, our preferred endogeneity-corrected results indicate that improvements in financial inclusion is associated with a reduction in food insecurity. This finding is consistent across different conceptualisations of food insecurity, alternative weighting schemes and cut-offs for the financial inclusion index and different quasi-experimental methods. Financial inclusion is mainly effective in reducing food insecurity in male-headed and rural-located households. Our findings reveal that entrepreneurship is an important pathway through which financial inclusion influences food insecurity.

Childhood food insecurity, mental distress in young adulthood and the supplemental nutrition assistance program

Article

Dec 2022
PREV MED

Food insecurity affects 14% of US homes with children and has been associated with increased mental health problems. Few studies have examined long-term consequences for mental health and the role of social policies. This study examined the association between childhood household food insecurity (HHFI) and young adult psychological distress, and the moderating role of caregiver psychological distress and the Supplemental Nutrition Assistance Program (SNAP) using data from the Panel Study of Income Dynamics (1995-2015). The sample comprised 2782 children ages 0-12 years in 1997. Past-year HHFI was measured using the USDA 18-item questionnaire in 1997, 1999, 2001 and 2003. Young adults' non-specific psychological distress was measured with the Kessler (K6) scale in 2005, 2007, 2009, 2011, 2013 and 2015. Three trajectories of food insecurity were identified: 1) Persistent food security (70.5%); 2) Intermediate/fluctuating food insecurity (24.6%), and; 3) Persistent food insecurity (4.9%). Compared to persistent food security, fluctuating and persistent food insecurity were associated with significantly higher levels of psychological distress. This association was robust to adjusting for socio-demographic factors, caregiver psychological distress, and family access to governmental supports: [Adj. ORs (95% CI's = 1.72 (1.59-1.85) and 2.06 (1.81-2.33)]. Having a caregiver who suffered from psychological distress (1997 and/or 2002) and growing up with persistent food insecurity placed children at greater risk for mental health problems. Access to SNAP attenuated this risk. Early HHFI is associated with psychological distress in young adulthood. Interventions to increase access to SNAP and address caregiver's mental health may prevent mental health problems associated with childhood HHFI.

Financial inclusion and food insecurity: Examining linkages and potential pathways

Article

Full-text available

Dec 2022

Both Sides of the Screen: Predictors of Parents’ and Teachers’ Depression and Food Insecurity During COVID-19-Related Distance Learning

Article

Feb 2022
EARLY CHILD RES Q

The COVID-19 pandemic has placed unprecedented strains on both parents and teachers, both of whose mental and financial hardships have serious implications for young children's wellbeing. We drew on an existing cohort study of families with low incomes in Tulsa, OK when children were in their Spring of 1st grade in 2020. We surveyed parents and teachers – children's caregivers on both sides of the screen during distance learning – before and after the COVID-19 pandemic hit and schools were closed. We first compared the proportion of parents and teachers who were depressed and food-insecure before and after the pandemic struck. We then used pre-pandemic characteristics of parents and teachers in separate models to predict their depression and food insecurity during the pandemic. Results showed that rates of depression among both parents and teachers spiked after COVID-19, and food insecurity rates also increased among parents. For both parents and teachers, the strongest predictor of depression during COVID-19 was having experienced depression before the pandemic. Similarly, the strongest predictor of food insecurity during COVID-19 was having experienced food insecurity beforehand. These results point intervention efforts towards identifying the caregivers of children in low-income contexts whose mental and financial wellbeing are likely to be most compromised during this and perhaps future disasters.

Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study

Article

Full-text available

Aug 2021
BMC Pediatr

Background Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program. Methods In this retrospective cohort study, data were extracted for all visits at one academic primary care clinic for all children aged 0–18 years whose parents/guardians had been screened for FI at least once between February 1, 2018 to February 28, 2019 (Year 1) and screened at least once between March 1, 2019 to February 28, 2020 (Year 2). Bivariate analyses tested for differences in FI and demographics using chi-square tests. Mixed effects logistic regression was used to assess change in FI between Years 1 and 2 with random intercept for participants controlling for covariates. The interaction between year and all covariates was evaluated to determine differences in FI change by demographics. Results Of 6182 patients seen in Year 1, 3691 (59.7%) were seen at least once in Year 2 and included in this study. In Year 1, 19.6% of participants reported household FI, compared to 14.1% in Year 2. Of those with FI in Year 1, 40% had FI in Year 2. Of those with food security in Year 1, 92.3% continued with food security in Year 2. Compared to Hispanic/Latinx participants, African American/Black (OR: 3.53, 95% CI: 2.33, 5.34; p < 0.001) and White (OR: 1.88, 95% CI: 1.06, 3.36; p = 0.03) participants had higher odds of reporting FI. African American/Black participants had the largest decrease in FI between Years 1 and 2 (− 7.9, 95% CI: − 11.7, − 4.1%; p < 0.0001). Conclusions Because FI is transitional, particularly for racial/ethnic minorities, screening repeatedly can identify families situationally experiencing FI.

Is home environment predictive of early grammar development?

Article

Full-text available

Dec 2024
J CHILD LANG

Research shows that children’s home environment (e.g., the composition of their household and the resources available in it) has an impact on children’s language development. However, this research has mostly been conducted among English speakers from the minority world and has often only considered vocabulary size. This exploratory study investigated whether home environment factors are predictive of grammar development in Afrikaans-speaking ( n = 117) and English-speaking ( n = 102) toddlers in South Africa. Moreover, potential differences between these two language groups were explored. Results showed that home environment factors pertaining to family stability predicted two of the three grammar scores, namely total grammar and complex phrases. Cluster analysis showed distinct patterns of home environment factors between Afrikaans and English-speaking households, illustrating the importance of measuring these factors even across samples from the same country. This study shows that children’s home environment is an interconnected system and cautions against oversimplified single-factor approaches.

Household Economic Hardship and Child Mental Health: The Mediating Role of Parents’ Mental Distress in a Southern European City

Article

Full-text available

Sep 2024
SOC INDIC RES

Previous research has dealt with whether low socioeconomic status directly affects a child’s mental health or if the relationship is mediated by the parent’s mental health. Few studies have used various household economic hardship measures within the same setting. The objectives are first to analyse the mediation effect of parents’ mental health on children’s mental health due to unemployment, material deprivation, and food insecurity, accounting for parenting practices and the neighbourhood environment, and second to identify differences between externalising and internalising mental health disorders. We use cross-sectional data from the Barcelona Health Survey for the year 2016, with a representative sample of 390 children from 4 to 14 years old in Barcelona city. The mental health of the respondent parent is measured with the General Health Questionnaire (GHQ-12 items) and that of the child with the Strength and Difficulties Questionnaire (SDQ-25 items). Mediation analysis is performed using pathway analysis under the Structural Equation Model. The association of the three economic hardship measures with overall child mental health confirms the mediating role of parents’ mental health. However, a direct effect on internalising mental health disorders remains for severe material deprivation and food insecurity, but not for externalising mental health disorders. The proxies for parenting practices play a moderate role. Violence in the neighbourhood is associated with poorer children’s and parents’ mental health across the models.

Food Insecurity and Family Dynamics: A Systematic Review

Article

May 2024

Background Undernutrition is related to numerous childhood outcomes. However, little research has investigated the relationship between food insecurity and family dynamics. This systematic review seeks to validate the evidence for a relationship between these 2 factors. Methods A systematic literature review was conducted in Embase, PubMed, and Scopus. Inclusion criteria include peer-reviewed research articles published during or after 1996 in English, using standardized measures of family function and food insecurity. Exclusion criteria include measurement of parent or child characteristics without assessing household or family characteristics or demographics. Two reviewers independently voted using Covidence, and Alpha agreement was determined at each phase. Results A total of 15 studies were included for data extraction after the initial search being completed in April 2022. All included studies were found to be appropriate in numerous categories for quality assessment. Primary findings from these studies show a potential relationship exists between food insecurity and family dynamics. Discussion The findings in this review suggest that effects of food insecurity expand to various aspects of healthy family functioning. Unhealthy family dynamics in childhood can also expose children to trauma and lead to increased physical and mental health disorders in the future.

Association and disparities of food insecurity and exposure to violence: analysis of the National Survey of Children’s Health

Article

Full-text available

Mar 2024

Context Lack of access to food is a significant concern for child well-being, and it creates many health disparities and adverse social outcomes. Food insecurity and its many associated risk factors increase parental stress, which are strongly correlated with an increased risk of child abuse and maltreatment. Research now identifies being witness to domestic abuse as a form of child maltreatment, and exposure to violence in the community has been shown to result in similar long-term impacts. Objectives Given the potential for lifelong adverse effects from experiencing adverse childhood events involving violence and food insecurity, our primary objective was to assess the relationship between the two and disparities among demographic factors. Methods We conducted an observational study utilizing data from the National Survey of Children’s Health (NSCH) 2016–2021. The NSCH is a United States nationally representative survey completed by primary caregivers of one child per home aged 0–17 years. We determined population estimates (n=216,799; n=83,424,126) and rates of children experiencing food insecurity and parent-reported exposure to violence. We then constructed logistic regression models to assess associations, through odds ratios (ORs), between food security and exposure to violence including demographic factors. Results Among the sample, 5.42 % of children experienced low food security and 7.4 % were exposed to violence. The odds of exposure to violence are 5.19 times greater for children with low food security compared to food-secure children (95 % confidence interval [CI]: 4.48–6.02). Indigenous and Black children were 7.8 and 6.81 times more likely to experience or witness violence when food insecure compared to food secure White children, respectively (95 % CI: 3.18–19.13, 5.24–8.86 respectively). Conclusions Food insecurity was associated with increased odds of children experiencing and/or witnessing violence compared to those who were food secure. The interaction between exposure to violence and food insecurity also disproportionately impacts children with specific demographic factors, notably race/ethnicity including multiracial, Indigenous, and Black children. By developing and adapting strategies to improve food security, it is possible to indirectly reduce the rates of childhood exposure to violence and the long-term impacts that result.

“You just have to spread it thin”: Perceptions and feeding experiences of Australian fathers of young children living with disadvantage

Article

Jan 2024
APPETITE

Trends and disparities in prevalence of cardiometabolic diseases by food security status in the United States

Article

Full-text available

Jan 2024
Nutr J

Background Previous studies have demonstrated the association between food security and cardiometabolic diseases (CMDs), yet none have investigated trends in prevalence of CMDs by food security status in the United States (US). Methods Serial cross-sectional analysis of the US nationally representative data from National Health and Nutrition Examination Survey (1999–2018) was conducted among adults aged 20 years or older. Food security status was defined by the US Household Food Security Survey Module (full, marginal, low, and very low food security). We estimated the age-adjusted prevalence of CMDs including obesity, hypertension, diabetes, and coronary heart disease by food security status. Racial and ethnic disparities in age-adjusted prevalence of CMDs by food security status were also assessed. Results A total of 49,738 participants were included in this analysis (weighted mean age 47.3 years; 51.3% women). From 1999 to 2018, the age-adjusted prevalence of CMDs was lower in full food secure group as compared with other groups. For example, trends in hypertension decreased from 49.7% (47.5-51.8%) to 45.9% (43.8-48.0%) (P-trend = 0.002) among the full and from 54.2% (49.9-58.5%) to 49.7% (46.8-52.6%) (P-trend = 0.02) among the marginal but remained stable among the low at 49.7% (47.9-51.6%) and among the very low at 51.1% (48.9-53.3%) (P-interaction = 0.02). Prevalence of diabetes increased from 8.85% (8.15-9.60%) to 12.2% (11.1-13.5%) among the full (P-trend < 0.001), from 16.5% (13.2-20.4%) to 20.9% (18.6-23.5%) (P-trend = 0.045) among the marginal and from 14.6% (11.1-19.0%) to 20.9% (18.8-23.3%) (P-trend = 0.001) among the low but remained stable at 18.8% (17.0-20.9) among the very low (P-trend = 0.35) (P-interaction = 0.03). Racial and ethnic differences in prevalence of CMD by food security status were observed. For example, among individuals with full food secure status, the prevalence of diabetes was 9.08% (95% CI, 8.60-9.59%) for non-Hispanic whites, 17.3% (95% CI, 16.4-18.2%) for non-Hispanic blacks, 16.1% (95% CI, 15.0-17.4%) for Hispanics and 14.9% (95% CI, 13.3-16.7%) for others. Conclusions and relevance Prevalence of CMDs was greatest among those experiencing food insecurity, and food insecurity disproportionately affected racial/ethnic minorities. Disparities in CMD prevalence by food security status persisted or worsened, especially among racial/ethnic minorities.

Is the Country Where a Child Lives Explanatory for Exposure to Physical Punishments? Examining Patterns on the Island of Hispaniola

Article

Full-text available

Dec 2023

Determining if where a child lives (country in the case of this study) is explanatory for exposure to physical punishments is often complicated by confounders. This study determined the odds of exposure to physical punishment for children living in the Dominican Republic (DR) and Haiti, the two countries that share the island of Hispaniola, after adjusting for a set of variables (socioeconomic, demographic, and belief about physical punishment). Three household samples with children between 1 and 14 years of age were extracted from national survey data from Haiti (2016–2017) and the DR (2014): (i) Haitian-Creole-speaking households in Haiti (“Creole-Haiti”) (n = 6009), (ii) Spanish-speaking households in the DR (“Spanish-DR”) (n = 17,094), and (iii) Haitian-Creole-speaking households in the DR (“Creole-DR) (n = 1123). The latter group provides an opportunity to contrast an immigrant population with populations from the site of immigration and emigration. Children in Creole-Haiti compared to Spanish-DR households had higher odds of exposure to all six physical punishments in unadjusted models, which drop to four after covariate adjustment. Children in Creole-DR households had higher odds of exposure to two physical punishments compared to Spanish-DR households and lower odds of exposure to four physical punishments compared to Creole-Haiti households in adjusted models. The persistence of differences in the odds of punishment exposures between groups, despite adjusting for several potential confounders, suggests the need for further inquiry into other factors associated with where a child lives to understand variation in punishment practices. Additional study of immigrant populations may be particularly informative.

The Intersection of Food Insecurity and Transportation Insecurity in Harris County, Texas

Article

Sep 2023

The importance of food in studying economic hardship and well-being: Does food insecurity mediate the associations between income and stress and well-being in a UK representative sample?

Article

Full-text available

Sep 2023
J Publ Health

Aim Efforts to tackle the global mental health crisis must be underpinned by a robust literature on the social determinants of mental health. Existing studies show consistent effects of economic hardship on mental health, emphasising the importance of basic needs, such as food. Outcomes are affected by family structure, with larger families and households with single adults experiencing greater budgetary strain. Our study aimed to investigate the extent to which effects of income on stress and well-being are mediated by food insecurity, whilst accounting for the effects of family size. Subject and methods We surveyed a nationally representative sample (n = 1004) of UK adults, collecting key demographic information, plus data on food security (Household Food Security Survey Module Six-Item Short Form), perceived stress (four-item Perceived Stress Scale), and well-being (Office for National Statistics’ four-item personal well-being measure). Results Our results demonstrated that meaningful portions of the effects of income on stress (44%) and well-being (37%) can be accounted for by food insecurity. We also found that 42% of the effect of family size on perceived stress could be accounted for by the increased food insecurity experienced by larger families. Conclusion Our results add to a growing body of evidence suggesting that tackling economic hardship and ensuring the satisfaction of material needs would support improved mental health outcomes. Further, given that evidence demonstrates important impacts of stress on other factors such as obesity and cognition, we argue that tackling poverty and ensuring food security would also have physical health benefits.

Parent Perception of School Meals in the San Joaquin Valley during COVID-19: A Photovoice Project

Article

Full-text available

Feb 2023

School-based nutrition programs are crucial to reducing food insecurity. The COVID-19 pandemic adversely impacted students’ school meal participation. This study seeks to understand parent views of school meals during COVID-19 to inform efforts to improve participation in school meal programs. Photovoice methodology was used to explore parental perception of school meals in San Joaquin Valley, California, a region of predominately Latino farmworker communities. Parents in seven school districts photographed school meals for a one-week period during the pandemic and then participated in focus group discussions and small group interviews. Focus group discussions and small group interviews were transcribed, and data were analyzed using a team-based, theme-analysis approach. Three primary domains emerged: benefits of school meal distribution, meal quality and appeal, and perceived healthfulness. Parents perceived school meals as beneficial to addressing food insecurity. However, they noted that meals were unappealing, high in added sugar, and unhealthy, which led to discarded meals and decreased participation in the school meal program. The transition to grab-and-go style meals was an effective strategy for providing food to families during pandemic school closures, and school meals remain an important resource for families experiencing food insecurity. However, negative parental perceptions of the appeal and nutritional content of school meals may have decreased school meal participation and increased food waste that could persist beyond the pandemic.

Does Food Insecurity in Early Life Make People More Depressed?—Evidence from CHARLS

Article

Full-text available

Jun 2022

Based on the China Health and Retirement Longitudinal Study (CHARLS) data, this paper estimates the long-term association between food insecurity and later adult health and health behaviors with the Probit model. The results show that food insecurity in early life significantly increases adults’ depression likelihood (measured by the CES-D scale). The food insecurity experience is also negatively and significantly associated with individual self-rated health status, memory, sleep quality, and life satisfaction. The negative association between food insecurity and cognitive ability and sleep hours is larger for females.

Food insecurity in pastoral communities of Ngorongoro conservation area, Tanzania

Article

Full-text available

Jun 2022

Background Food insecurity increases the risks of hunger and malnutrition and remains a formidable health challenge in resource-poor settings. Pastoral communities, which are largely restricted to marginal lands, tend to experience heightened levels of food insecurity. However, empirical evidence of food insecurity for communities living on the edge of conservation areas is limited. This study assessed the prevalence and determinants of food insecurity in pastoral communities of Ngorongoro, Tanzania. Methods Data were collected through a household survey (n = 238), key informant interview and field observation. Food insecurity was measured through Household Food Insecurity Access Scale (HFIAS). Data were subjected to descriptive statistics, principal component analysis, and multivariate regression analysis. Results Based on three HFIAS domains, the surveyed communities experience anxiety and uncertainty about food supply (77.3% of the households), insufficient quality in terms of variety and preferences (74.1%), and insufficient food intake (55.9%). Overall, more than half (55%) of the households are food insecure. Multivariate logistic regression models adjusted for socio-demographic characteristics show that household food insecurity is independent of socio-demographic factors. Culture, environmental factors, and production system determine food access, food consumption practices, and overall household food security. The odds of food insecurity are higher in households whose location to the market exceeds 5 km [AOR (95% CI) = 6.20 (1.66–9.09)] and those reporting limited access to water [AOR (95% CI) = 1.09 (0.17–6.43]. A similar pattern is recorded in households not owning small stocks [AOR (95% CI) = 1.12 (0.41–1.65)] or donkeys [AOR (95% CI) = 1.19 (0.18–7.65)]. Conclusion Empirical evidence shows that the prevalence of food insecurity in the study community is high. This situation emanates from a wide range of factors including those linked to culture, physical environment, and production system. Thus, interventions are needed to leverage nutrition education, promote sustainable energy technologies, and develop strategic social service infrastructure in the community development zone. There is also a need to look into long-term settlement plans with the view to improve the welfare of the pastoral communities.

Understanding the Wellbeing of Early Educators in the Wake of the Coronavirus Pandemic: Lessons from Louisiana

Article

May 2022
EARLY CHILD RES Q

Food insecurity, depressive symptoms, and the salience of gendered family roles during the COVID-19 pandemic in South Africa

Article

Full-text available

Feb 2022

Debra Shepherd

Extensive research has indicated food insecurity to be associated with depressive symptoms, both of which have been indicated to increase globally during the COVID-19 pandemic. Few studies, however, have made use of nationally representative and longitudinal data to investigate this relationship, making causal claims difficult. In South Africa (SA), as with other low- and middle-income contexts, population-based studies have generally focused on mothers during the perinatal period and other vulnerable groups. This study made use of Cross-Lagged Dynamic Panel Models to examine the relationship between household food insecurity and the depressive symptoms of adults across three waves of the National Income Dynamics Survey–Coronavirus Rapid Mobile Survey (NIDS-CRAM) study collected in 2020 and 2021, a dataset nationally representative of all adults in SA in 2017. Stratification of the sample by gender, parenthood and marital statuses allowed for the assessment of gender differences in family roles that might account for differential impacts of food insecurity on mental health outcomes. The findings of this study indicated a significant impact of food insecurity on the depressive symptoms of adults. Controlling for stable trait-like individual differences eliminated much of this relationship, indicating partial or full mediation by unobserved factors. Gender differences in food security's association with depressive symptoms amongst cohabitating parents following the inclusion of individual effects provided support for a gendered role response. These findings provide further evidence of the complex interactions between sex, gender and health.

The Correlation between Food Insecurity and Infant Mortality in North Carolina

Article

Full-text available

Jan 2022

Objective Food insecurity (FI) affects approximately 11.1% of US households and is related to worsened infant outcomes. Evidence in lower income countries links FI and infant mortality rates (IMR), but there are limited data in the United States. This study examines the relationship between FI and IMR in North Carolina (NC). Design NC county-level health data were used from the 2019 Robert Woods Johnson Foundation County Health Rankings. The dependent variable was county-level IMR. Eighteen county-level independent variables were selected and a multivariable linear regression was performed. The independent variable, FI, was based on the United States Department of Agriculture’s Food Security Supplement to the Current Population Survey. Setting North Carolina counties Participants Residents of North Carolina, county-level data Results The mean NC county-level IMR was 7.9 per 1000 live births compared to 5.8 nationally. The average percent of county population reporting FI was 15.4% in the state vs 11.8% nationally. Three variables statistically significantly predicted county IMR: percent of county population reporting FI; county population; and percent population with diabetes (p values, respectively, < 0.04; < 0.05; < 0.03). These variables explained 42.4% of the variance of county-level IMR. With the largest standardized coefficient (0.247), FI was the strongest predictor of IMR. Conclusions FI, LBW and diabetes are positively correlated with infant mortality (IM). While correlation is not causation, addressing FI as part of multifaceted social determinants of health might improve county level IMR in NC.

Chaos during the COVID ‐19 outbreak: Predictors of household chaos among low‐income families during a pandemic

Article

Sep 2021

Objective The objective of this study was to explore whether household chaos measured during the COVID-19 pandemic is predicted by prepandemic parental and household characteristics. Background The COVID-19 pandemic has dramatically altered children's home environments and routines due to stay-at-home orders, school closures, and economic shocks. These disruptions have been especially challenging for low-income families who have limited resources and have been disproportionately affected by the pandemic. Household chaos, which captures routines, organization, stability, noise, and crowding in the home, is a documented threat to parent functioning and positive child development. The pandemic has likely exacerbated household chaos, especially for low-income families. Method Data come from a larger, ongoing study of low-income children and their parents in Tulsa, OK; this analysis relies on data from the subset of low-income parents who responded to surveys when their children were in kindergarten (in 2018–2019) and during the pandemic, when their children were in first grade (n = 335). We use multivariate ordinary least squares regression models to test whether household chaos measured during the pandemic is predicted by prepandemic parental and household characteristics. Results Prepandemic parental depression and household chaos were significantly predictive of chaos during the pandemic, even after accounting for household demographics. Implications The current study highlights pandemic-induced elevations in parental distress and household chaos among low-income families. Results will provide valuable direction to policymakers, educators, and parents on how best to offset negative impacts of the COVID-19 pandemic on family functioning and child development.

Addressing Mental Health and Social Needs in Tandem to Promote Health Equity

Article

Aug 2024
Pediatr Clin

Emergency Allotments in SNAP and Food Hardship Among Households With Children

Article

Aug 2024

Importance Households with children and minoritized racial and ethnic groups experience a disproportionate burden of food hardship. During the COVID-19 pandemic, the US federal government implemented emergency allotments in the Supplemental Nutrition Assistance Program (SNAP), increasing the amount of food purchasing assistance received by many participating households. Objective To examine the association of implementing emergency allotments in SNAP with food hardship among households with children overall and for households with Black, Hispanic, and White children by comparing income-eligible households that did and did not participate in SNAP. Design, Setting, and Participants This ecologic cross-sectional study used 2016-2022 National Survey of Children’s Health data and a difference-in-differences approach to compare changes in the risk of food hardship from before implementation of emergency allotments in SNAP (2016-2019) to during implementation (2020-2022). Households with children younger than 18 years and incomes 130% or less of the federal poverty level (FPL) in all 50 states and Washington, DC, were included. Exposure Implementation of emergency allotments in SNAP. Main Outcome and Measures The primary outcome was caregiver report of household food hardship during the past 12 months. Results Of 44 753 households with incomes 130% or less of the FPL, a weighted 23.4% had Black children, 56.7% had White children, and 19.9% had children of other races. More than one-third of households (37.8%) had Hispanic children, and 31.8% had young children aged 0 to 5 years. The percentage of households that experienced food hardship decreased from 2016 to 2021 (from 62.9% to 48.2% among SNAP-participating households and from 44.3% to 38.9% among income-eligible nonparticipating households) but increased in 2022 (to 58.0% among SNAP-participating households and to 47.5% among nonparticipating households). Adjusting for confounders, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating compared with nonparticipating households (risk ratio [RR], 0.88; 95% CI, 0.81-0.96). Implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating households with Hispanic (RR, 0.86; 95% CI, 0.72-1.02) and White (RR, 0.85; 95% CI, 0.76-0.94) children compared with nonparticipating households but not among households with Black children (RR, 1.04; 95% CI, 0.87-1.23). Conclusions and Relevance In this ecologic cross-sectional study, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among households with children. Efforts are needed to ensure that all populations benefit from economic policies.

The expanded Child Tax Credit and low-income families’ food insecurity: Associations across and within months of receipt

Article

Aug 2024
CHILD YOUTH SERV REV

Food Insecurity and Children's Problem Behaviors: The Mediating Role of Parental Relationship Quality and Parenting Stress

Article

Jun 2024

Objective Food insecurity, identified as a critical stressor for many families, can directly and indirectly influence children's development through interparental relationships and parenting. This study examines how food insecurity relates to children's problem behaviors and the mediating roles of interparental relationship quality and parenting stress. It also investigates the association between parents' perception of relationship quality and both their own and their partner's parenting stress. Method The study included 2095 children from the Future of Families and Child Wellbeing Study. The actor partner interdependence model was used to explore the actor and partner influence of relationship quality on parents' parenting stress. To examine the association pathways from food insecurity to children's problem behaviors, a structural equation model was conducted. Results Results suggest that fathers' perception of couple relationship quality predicted both their own and their partner's parenting stress while mothers' perception of couple relationship quality only predicted their own, but not fathers', parenting stress. In the positive association between food insecurity and children's problem behaviors, there was a serial mediation through mothers' perception of relationship quality and mothers' parenting stress. In addition, food insecurity was negatively correlated with mothers' perception of relationship quality, but not with that of fathers. Conclusion This study highlights the pathway from food insecurity to children's problem behaviors through mothers' perceptions of interparental relationship quality and parenting stress. Results provide support for the family stress theory and offer valuable insights for the formulation of potential prevention and intervention programs.

Applying the Family Stress Model to responsive feeding and early obesity prevention

Article

May 2024
APPETITE

Associations Between Daily Food Insecurity and Parent and Child Well-Being

Article

Full-text available

Mar 2024

Food insecurity poses a serious threat to children’s development, but the mechanisms through which food insecurity undermines child development are far less clear. Specifically, food insecurity may influence children through its effect on parents’ psychological well-being and parent–child interactions as a result, but past research on the role of parents is correlational and undermined by omitted variable bias. Using a partially rural, low-income sample of parents living in Pennsylvania (N = 272, 90% mother, Mage = 35) and their school-aged children (ages 4–11, 50% female) alongside daily measures of parent-reported food insecurity and parent and child mood and behavior, we examine how daily changes in food insecurity predict daily changes in parent and child well-being, and the extent to which food insecurity operates through parents to affect children. This method not only explores families’ daily, lived experiences of food insecurity, but improves upon the methodological issues undermining past research. Findings indicate that food insecurity influences parent and child well-being on a daily basis, but that associations are stronger and sustain longer for parents than children. Further, parent mood and behavior partially explain the association between daily food insecurity and child mood and behavior, but food insecurity is also independently associated with child well-being. This study is the first to examine daily associations between food insecurity and parent and child well-being. Its implications for food assistance programs, policies, and the future of food insecurity research are discussed.

Household Health-Related Social Needs in Newborns and Infant Behavioral Functioning at 6 Months

Article

Full-text available

Dec 2023

Importance Dysfunctional patterns of behavior during infancy can predict the emergence of mental health disorders later in childhood. The Baby Pediatric Symptom Checklist (BPSC) can identify indicators of behavioral disorders among children aged 0 to 18 months. Understanding the association of early health-related social needs (HRSNs) with poor infant behavioral functioning can inform interventions to promote early childhood mental well-being. Objective To examine the association between household HRSNs in the first 4 months of life and BPSC results at 6 months. Design, Setting, and Participants This was a retrospective cohort analysis of longitudinal electronic health record data. Covariates were selected based on the biopsychosocial ecological model. Logistic regression analyses examined the association of HRSN domains and the number of HRSNs with the 6-month BPSC outcomes. Participants were recruited from 6 primary care clinics within 1 health system. Children aged 5 to 8 months who were evaluated for 6-month well-child visits between March 30, 2021, and June 30, 2022, were included in the study. Exposure Responses to the first HRSN screening tool that a caregiver completed for infants between 0 and 4 months of age. HRSN domains were examined individually and as the number of positive HRSNs. Main Outcome and Measures BPSC screen identified for clinical review due to 1 or more elevated subscales (inflexibility, irritability, and difficulty with routines) at 6 months. Results A total of 1541 children (mean [SD] age, 6.1 [0.5] months; 775 female [50.3%]) were included in the study. A total of 405 children (26.3%) had a BPSC screen identified for clinical review, and 328 caregivers (21.3%) reported at least 1 HRSN. Food insecurity (174 [11.3%]) and benefits issues (169 [11.0%]) were the most frequently reported HRSN. Children in households with food insecurity had statistically significant higher odds of inflexibility (adjusted odds ratio [aOR], 1.73; 95% CI, 1.14-2.63), difficulty with routines (aOR, 1.64; 95% CI, 1.05-2.57), and irritability (aOR, 1.86; 95% CI, 1.13-3.08) than children in households without food insecurity. Children in households with benefits issues had statistically significant higher odds of difficulty with routines (aOR, 1.70; 95% CI, 1.10-2.65) and irritability (aOR, 1.70; 95% CI, 1.03-2.82). Children in households with 2 or more HRSNs had consistently higher odds of having a BPSC screen identified for clinical review (aOR, 2.16; 95% CI, 1.38-3.39) compared with children with no HRSNs. Conclusions and Relevance Results of this cohort study suggest that household food insecurity, benefits issues, and the number of HRSNs were significantly associated with a BPSC screen identified for clinical review at 6 months of age. These findings highlight the urgency of intervening on HRSNs in the newborn period to prevent adverse infant behavioral outcomes.

The Relationship of Socioeconomic and Household Food Security among Smallholder Glutinous Rice Famers in Langkawi, Malaysia

Article

Full-text available

Dec 2023

Smallholder farmers are a group that is vulnerable to food insecurity due to the various challenges they face, such as low income, natural disasters, and relatively remote living areas. This study aims to explore the relationship between socioeconomic status and household food security among smallholder glutinous rice farmers in Langkawi, Malaysia. The research will employ a quantitative approach, using Household Insecurity Access Scale (HFIAS). Analyze the linkages, using correlation and multiple regression, between the respondent’s income, respondent’s education, the age of the household head, wife’s income, land size, and household food security. In this study, it was found that there were several groups such as food secure (64.9%), mildly f The prevalence of food insecurity (mildly, moderately, severely) among respondents was 30.5% or 3.5 out of 10 people. Food insecure (15.2%), moderate food insecure (12%), and severely food insecure (5.1%). The research results show that the respondent’s income (p=0.000**), the respondent’s education (p=0.008**), and the wife’s income (p=0.045*) are variables that have a relationship with household food insecurity. In conclusion, the result showed that the respondent’s income, the respondent’s education, and the wife’s income have relationship with food security. In its application the author recommends, the relationship between socioeconomic variables and household food security can be a guide for governments, non- profit organizations and related institutions to make policies.

“Taking from Peter to pay Paul”: The experience of people in receipt of fuel and food vouchers from a UK foodbank

Article

Sep 2023

For people on very low incomes, household fuel and food environments are increasingly uncertain. Many live in precarious situations with little control over their lives. In addition to food parcels, many foodbanks also supply emergency fuel payments. There has been a surge in demand due to the cost of living crisis in the United Kingdom. This qualitative study, using semi‐structured interviews, explored the lived experience of people who received a fuel voucher via a foodbank to gain insights into food preparation, eating practices and heating and appliance use in their homes. All participants ( n = 6) described a change in life circumstances leaving them at crisis point with overwhelming uncertainty. Using Thematic Analysis, we identified four themes: (1) Bewilderment in using foodbank services; (2) The need to make trade‐offs between food and fuel; (3) Feeling shame at using the services and (4) Missing out on pleasurable eating practices. Three case studies give fuller insights and context. All interviewees had acute and complex needs and described being ‘at rock bottom’, with fuel vouchers viewed as a ‘lifeline’ to address essential cooking, heating and electrical appliance needs. We, therefore, suggest the need for extra support and follow‐up for first‐time users who are in a state of denial and shock when seeking help. Further research is needed on how to best help organisations develop strategies to address and ameliorate a sense of powerlessness and shame felt by their clients which likely limits them from seeking help, despite being in acute, complex and dire need.

Food insecurity and delayed or forgone health care among pregnant and postpartum women in the United States, 2019-2021

Article

Jul 2023
NUTRITION

Objective Despite the growing crisis of food insecurity in the US, there is limited evidence about the impact of food insecurity on unmet health care needs for peripartum (pregnant and postpartum) women. This study examines the association between food insecurity and delayed or forgone healthcare among peripartum women in the United States from 2019 to 2021. Methods We conducted a pooled cross-sectional analysis using data from the 2019, 2020, and 2021 National Health Interview Surveys. Food security status was defined by type (high/marginal, low, and very low). Descriptive analysis and multivariable logistic regression, adjusted for sociodemographic and health-related characteristics, were conducted to estimate the overall and specific delayed or forgone health care (yes or no) between the different categories of food security. Results Of the 1,525 peripartum women (Weighted, N = 5,580,186), 10.7% of peripartum women in the US experienced suboptimal food security in the preceding 12 months between 2019 and 2021, with 5.3% experiencing low and 5.4% experiencing very low food security. This included 6.2% (95% CI, 4.9%-7.7%) who reported delaying filling a medical prescription, 6.4% (95% CI, 5.0%-8.2%) who needed counseling or therapy from a mental health professional but did not receive it, 5.9% (4.6%-7.6%) who delayed counseling or therapy from a mental health professional, 7.6% (95% CI, 6.0%-9.6%) who needed medical care but did not receive it, and 8.6% (95% CI, 6.9%-10.3%) who delayed medical care. Peripartum women with low and very food security were more likely to delay or forego health care due to cost concerns than peripartum women who were food secure. In the multivariable analyses adjusted for predisposing, enabling and need-based factors, those with low and very low food security had higher risk of delayed or forgone health care compared to women with marginal/high food security. Conclusion In this study, we demonstrated a positive association between food insecurity and cost-related unmet healthcare needs among peripartum women. Future empirical studies are needed to assess the impact of peripartum healthcare interventions targeting food insecurity on reducing healthcare access disparities associated with costs and improving peripartum health outcomes. Keywords Food insecurity; Healthcare; Access: Affordability; Unmet needs; Pregnant; Postpartum

Cross-Sector Intervention Strategies to Target Childhood Food Insecurity in North Carolina

Article

Full-text available

Jul 2023
N C Med J

Background Childhood food insecurity increased considerably during the COVID-19 pandemic and is associated with compromised health. Health care systems are increasingly prioritizing food insecurity interventions to improve health, but it is unclear how health systems collaborate with other sectors that are addressing food insecurity. In this study, we aimed to evaluate existing collaborations and explore opportunities for further cross-sector engagement. Methods From December 2020 to March 2021, we conducted semi-structured interviews (N = 34) with informants involved in increasing child food access in North Carolina. Our informants represented different sectors, including community (e.g., food pantry), education (e.g., school lunch program), and government (e.g., Supplemental Nutrition Assistance Program). Rapid qualitative analysis was used to interpret the results and identify themes. Results Informants rarely mentioned the health care sector as a source of referrals or as a collaborator. Barriers limiting access to food insecurity programs were exacerbated by the COVID-19 pandemic, including lack of transportation, stigma deterring use, limited food choice, and burdensome enrollment processes. Stakeholders recommended mitigating barriers through the expansion of food delivery, co-localization of assistance programs in schools and health care settings, increased food choice, and supporting cross-program enrollment mechanisms. Limitations The majority of the stakeholders represented programs from five counties in central North Carolina, with only a few representing statewide initiatives. Conclusions The COVID-19 pandemic both highlighted the fragmented system of food insecurity organizations and accelerated development of cross-sector collaborations to reduce access barriers. Health care systems are siloed from school and community efforts but have the opportunity to leverage ongoing innovative policy initiatives to construct novel cross-sector models. Such models can better link food insecurity screening with community-based solutions to address family-level food access barriers.

Fathers’ Marital Conflict and Children’s Socioemotional Skills: A Moderated-Mediation Model of Conflict Resolution and Parenting

Article

Full-text available

May 2023

Marital conflict is common in many families. The effects of marital conflict may often spill over to parent–child dyads and affect children’s development via their parenting practices. However, couples handle their marital conflict in different ways, and conflict resolution strategies may play a role in children’s outcomes. Although mother-reported marital conflict has been a primary focus in most prior studies, little is known about fathers’ perspectives. To that end, we examined the mediating effect of fathers’ parenting in the association between the frequency of marital conflict and mother-reported children’s socioemotional skills in preschool, as well as the moderating role of father constructive conflict resolution frequency in the association between father reports of the frequency of the marital conflict and parenting. Results indicate that father parenting warmth and parenting stress mediated the association between the frequency of marital conflict and children’s socioemotional skills. We also found that father reports of the frequency of the marital conflict was positively associated with involvement and negatively associated with warmth at higher levels of constructive conflict resolution frequency. Fathers who reported higher constructive conflict resolution frequency showed higher father involvement and warmth. Finally, the moderated-mediation analysis revealed that, after accounting for mothers’ parenting variables, father warmth was the moderated mediator, such that there was a negative indirect effect between the frequency of marital conflict and children’s socioemotional skills through father warmth at average and higher levels of constructive conflict resolution frequency.

The Role of Public and Private Food Assistance in Supporting Families’ Food Security and Meal Routines

Article

May 2023
CHILD YOUTH SERV REV

Patterns and predictors of material hardship among poor families with children

Article

Dec 2022

Kate Marcal

Experiences of material hardship vary across poor families, but little is understood about this variability. The present study aimed to distinguish subtypes of material hardship as well as which characteristics predict subtypes. Latent class analysis with data from a large, longitudinal study of families with youth children investigated subtypes of material hardship as well as predictors of subtypes. Multinomial logistic regression then predicted class membership used on known housing risk factors maternal IPV victimization, depression, and substance use. Analyses identified three distinct subtypes of material hardship: “Housing Insecure,” “Food Insecure,” and “Cost‐Burdened but Managing.” Maternal IPV victimization and depression reduced likelihood of membership in the “Managing” class, but no predictors distinguished families who become food versus housing insecure. Findings suggest widespread financial stress and complex tradeoffs for low‐income families, who struggle to afford basic needs. Maternal safety and mental health prove crucial to families' coping abilities. Increased systemic supports targeting specific circumstances may promote stability and prevent more severe hardship.

References

Article

Oct 2022

Fathali M. Moghaddam

Psychology is a discipline with global influence, but continues to neglect disadvantaged minorities and continues to adopt an incorrect model of science. This volume explains what has gone wrong, and what steps should be taken for psychology to become a constructive international force. Historically, psychologists have focused only on causal explanations of behavior, neglecting normatively regulated behavior and intentionality. By giving greater importance to context and collective processes, moving from 'societies to cells,' psychologists can better understand and explain individual behavior. Poverty is an extremely powerful context that shapes cognitions and actions, with destructive consequences for disadvantaged individuals. The advocation of 'be happy psychology' and 'resilience' as solutions to problems faced by the disadvantaged leads to entrenched group-based inequalities, with the poor stuck at the bottom. Moving forwards, this volume proposes that psychologists should focus on normative systems to ultimately foster a more balanced field of study for the future.

Impacts of COVID-19 on the home food environment and eating related behaviors of families with young children based on food security status

Article

Oct 2022
APPETITE

This mixed-methods study endeavored to expand the current understanding of how early pandemic related disruptions impacted the home food environment and parent feeding practices of families with young children. Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2–5 year old children. Individual interviews were conducted by phone and video conference with mothers (n = 25) during August/September of 2020 and were coded using a hybrid deductive/inductive analysis approach. Parents also reported on their family's food insecurity status enabling qualitative findings to be stratified by family-level food security status. Two overarching themes were identified related to how families in this sample describe the COVID-19 pandemic's impact on their home food environment. Themes included 1) Impacts on obtaining food for one's family, and 2) Specific changes in parent feeding practices. Findings indicated variation within each theme by family food security status. Overall, families experiencing food insecurity more frequently discussed using various coping strategies, including stocking up, rationing food, and use of supplemental food resources, to overcome challenges associated with obtaining food brought on by COVID-19. Families with food insecurity also reported having more time for home cooked meals and more frequently discussed enforcing less structure (timing of meal, place) related to meals/snacks consumed at home during the pandemic. The impacts of the COVID-19 persist, ranging from ongoing economic challenges, inconsistent access to childcare for families, and the emergence of new, more contagious, variants. With this, interventions to address food insecurity amongst families with young children should consider how to optimize the home food environment and promote healthful parent feeding practices within the families they serve in the face of an evolving public health crisis.

Use of the Emergency Food System among Food Insecure, Low-income Households in the United States 2015 to 2020

Article

Oct 2022

The emergency food system (EFS) is a critical part of the United States’ social safety net. Using 2015–2020 Current Population Survey Food Security Supplement data, we identified trends in EFS use among food insecure, low-income households by estimating the probability of EFS use adjusting for demographics using multivariable logistic regression. From 2015 to 2019, between 31.0% and 34.4% of households received emergency food, while 42.4% did in 2020. EFS use did not increase in 2020 compared to prior years for older adults and non-metropolitan households. Targeted outreach should be used to expand the reach of this resource to underserved and marginalized populations.”

Association of Food Insecurity with Mental Health Outcomes in Parents and Children: A Systematic Review

Article

May 2022

Background Food insecurity affects 13.7 million U.S. households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. Objective To identify the associations of food insecurity and mental health outcomes in parents and children Data Sources PubMed, Embase, Web of Science, and PsycInfo Study Eligibility Criteria We included original research published in English from January 1990 – June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the U.S. Study Appraisal and Synthesis Methods Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. Results We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. Limitations Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. Conclusions and Implications of Key Findings Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.

Independent and combined associations of intimate partner violence and food insecurity on maternal depression and generalized anxiety disorder

Article

Jan 2022
J ANXIETY DISORD

While research has investigated intimate partner violence (IPV) and food insecurity (FI) as independent experiences on mental health, research is lacking on the possible longitudinal associations of combined experiences of IPV and FI on maternal depression and generalized anxiety disorder (GAD). Using data from the Fragile Families and Child Wellbeing study (n=1,440), the current study examined the independent and combined associations of IPV and FI mothers experienced 3-5 years after their child’s birth on depression and GAD at Year 15. Five mutually exclusive dichotomous variables were created based on IPV and FI experiences during Year 3 and Year 5. Depression and GAD were measured at Year 15 using the Composite International Diagnostic Interview-Short Form. According to the covariate-adjusted logistic regression models, exposure to IPV and FI, both concurrently and independently predicted greater depression at Year 15. Mothers in all IPV and FI categories had greater odds of having GAD at Year 15 compared to those with no exposure. Compared to the independent effect of IPV and FI, the combined effect of IPV and FI was highly associated with maternal GAD, but not depression. Using a trauma-informed approach to counseling in combination with food assistance programs might be an effective strategy in preventing mental health symptoms.

Time-Varying Associations Between Food Insecurity and Infant and Maternal Health Outcomes

Article

Jan 2022
J NUTR

Background: Food insecurity (FI) is dynamic for families and adversely impacts infant and maternal health. However, few studies have examined the longitudinal impact of FI on infant and maternal health. Objective: We aimed to examine the relationship between food insecurity in the first year of life and infant and maternal health outcomes. We hypothesized FI would be associated with poorer infant and maternal health outcomes. Methods: We conducted a retrospective cohort study of 364 infants 12-15 months and their caregivers receiving care at a single primary care clinic. The exposure of interest was food insecurity measured during well-child checks using a validated 2-item screening tool. The primary outcome was infant weight-for-length z-score. Secondary outcomes included infant log-transformed ferritin, infant hemoglobin, infant lead levels, and maternal depression, assessed by the Edinburgh Postnatal Depression Scale. Unadjusted and adjusted effects were estimated using generalized mixed linear models, and the linear effect of visit time was tested using likelihood ratios. Results: In adjusted models, no overall association between FI and infant weight-for-length z-score was observed; however, FI male infants had lower weight-for-length z-scores than female infants (p = 0.05). FI infants had 14% lower log ferritin levels per month of exposure to FI. FI was positively associated with maternal depression (IRR 5.01 [95% CI 2.21-11.3]). Conclusion: Food insecurity can have longitudinal and demographically-varied associations with infant and maternal outcomes that warrant further exploration.

Profiles of Young Children Involved with Child Protection Services in Portugal

Article

Full-text available

Jun 2022
CHILD INDIC RES

Many maltreated young children have their first contact with Child Protective Services (CPS) through Emergency Shelter Care (ESC) in response to an immediate need for protection or to complete a case diagnosis and placement decision. However, little is known about the characteristics of young children at the entry point into ESC, such as risk and protective factors and, in particular, their family characteristics. The purpose of this study is to identify the profiles of families and young children who have been removed from their families and placed in ESC. We did so with a needs-led and evidence-based methodology, which can be incorporated into CPS practices to promote better-informed decisions in subsequent services and programs’ interventions. A sample of 100 young children admitted to a Portuguese ESC was analyzed based on their risk and protective factors, as well as risk thresholds in five dimensions: 1) living situation; 2) family relationships; 3) social behavior; 4) physical and psychological health; and 5) family education and employment. Four distinct needs profiles with different degrees of risk for young children’s development and well-being were identified. The existence of different patterns of needs requires specific and differentiated services’ interventions. The results and implications for practice are discussed.

Food insecurity, food parenting practices, and child eating behaviors among low-income Hispanic families of young children

Article

Dec 2021
APPETITE

Food insecurity is associated with negative food parenting practices that may promote child obesity, including pressure to eat and food restriction. Less is known about the relationship between food insecurity and positive food parenting practices, including exposing the child to new foods and involving the child in food preparation. Further, few studies have investigated the associations between food insecurity and child eating behaviors that have been linked to poor dietary outcomes. Using baseline data collected as part of a larger pilot intervention, we examined the relationships between food security status, food parenting practices, and child eating behaviors in a predominately Hispanic, low-income sample of parents and their preschool aged children (n = 66). Between July of 2019 and 2020, caregivers recruited from 4 urban communities in Rhode Island completed assessments of household food security, food parenting practices, and four child eating behaviors: food responsiveness, emotional overeating, enjoyment of food, and satiety responsiveness. Although 46% of caregivers reported food insecurity, food insecurity was not directly associated with any food parenting practice. Children in food insecure households were rated as higher in levels of food responsiveness and enjoyment of food as compared to children in food secure households. Children in food insecure households were rated as lower in satiety responsiveness as compared to children in food secure households. Child emotional overeating did not vary by food security status. Future interventions to reduce child obesity among low-income Hispanic families should assess food security status and consider any level of food insecurity as a potential signal of unhealthy child eating behaviors.

Food Insecurity in Toddlerhood and School Readiness: Mediating Pathways Through Parental Well-Being and Behaviors

Chapter

Oct 2021

Food insecurity in the United States is both widespread among families with children—currently affecting nearly one in three families—and especially damaging during early childhood, in part because of its links to children’s language, mathematics, and socio-emotional skills at school entry. In order to alleviate this problem, it is imperative to know how food insecurity impacts development, yet little research has looked at this question. Using nationally representative data, we explore whether a broad set of parent well-being and behavioral factors serve as links between food insecurity in toddlerhood and skills at kindergarten entry. We find that the relationship between food insecurity and development is mediated by parent depression and stress, but not by the use of cognitively stimulating activities at home or by observed parenting behaviors. This suggests that efforts to reduce the impact of food insecurity on children should also prioritize parental well-being. Policy implications are discussed.

Early Childhood WIC Receipt and Cognitive and Socioemotional Outcomes at School Entry and Middle Childhood

Chapter

Oct 2021

The goal of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is to support the health and well-being of low-income women, infants, and children by providing pregnant women, and children up to 5 years old, with access to nutritious food. While the health benefits of WIC for young children have been well established, its potential non-health benefits, including improvements in children’s early cognitive and socioemotional well-being, are underexplored. The goal of this present study is to identify associations between WIC receipt in early childhood and cognitive and socioemotional outcomes at school entry and in middle childhood. Using sibling fixed effect models and data drawn from the National Longitudinal Survey of Youth-Child Supplement (NLSY-CS, N = 4500), the present study finds that WIC receipt in early childhood predicts lower behavior problems at school entry, although those effects fade by middle childhood. These results suggest the benefits of WIC extend beyond health outcomes to include outcomes important to children’s early school success.

The contribution of school meals to food security among households with children and adolescents in Brazil

Article

Full-text available

Jan 2022
NUTRITION

Objective To study the relationship between food insecurity and school meal consumption, adjusted for socio-demographic variables. Methods This cross-sectional study investigated households with children and adolescents living in Brazilian municipalities. A semi-structured survey was administered to parents/guardians at a parent and teacher meeting to assess their socioeconomic conditions and access to food using the Brazilian Food Insecurity Scale, that classifies households in food security or in mild, moderate or severe food insecurity. Parents and students were asked about the frequency of their consumption of school meals offered by the Brazilian School Food Program, that's one of the largest public policies in Brazil and offers free meals to all students in all public schools. Multinomial regression was performed to assess the relationship between food security and frequency of school meal consumption. Results A total of 1,705 students participated in the study, most of whom displayed some degree of food insecurity (56.5%), according to the Brazilian Food Insecurity Scale. Regular (more than 3 times/week) consumption of school meals was reported by 78.5% of students. Regarding the frequency of school meal consumption adjusted by socio-demographic variables, we found that students from households with food insecurity (moderate or severe) were more likely to regularly consume school meals. The prevalence of households with moderate or severe food insecurity was twice higher than those who lived in food security households, after adjusting for socio-demographic variables (2.35 - 95%CI 1.53-3.61). Conclusion The Brazilian School Food Program has contributed greatly to food security. While the guarantee of universality is essential for Program to reach all schoolchildren who are experiencing food insecurity, the program should also aim for greater equity.

Nutrition and Brain Development: Social Policy Implications

Article

Full-text available

Apr 2002

Undernutrition among young children is widespread in the United States and has a detrimental impact on brain development. This article explores the risks associated with undernutrition and the potential for recovery when diet and the environment improve. Three policy implications are discussed: (a) increasing access to federal food programs, (b) promoting breastfeeding, and (c) working toward reducing child poverty.

Does Household Food Insecurity Affect Parental Characteristics and Child Behavior? Evidence from the Panel Study of Income Dynamics (PSID)

Article

Full-text available

Predictors of Delayed or Forgone Needed Health Care for Families With Children

Article

Full-text available

Nov 2012
Pediatrics

Background: We sought to determine how health care-related financial burden, childhood activity limitations, health insurance, and other access-related factors predict delayed or forgone care for families with children, using a nationally representative, population-based sample. Methods: Our sample included families with children aged 0 to 17 years whose family was interviewed about their health care expenditures in 1 of 7 panels of the 2001 to 2008 Medial Expenditure Panel Survey (N = 14 138). Financial burden was defined as (1) the sum of out-of-pocket health service expenditures during the first survey year and (2) that sum divided by adjusted family income. Delayed or forgone care was defined as self-report of delayed or forgone medical care or prescription medications for the reference parent or child during the second survey year. Results: Financial burden, discordant insurance, and having a child with an activity limitation were some of the strongest predictors of delayed or forgone care. Additionally, significant health insurance and income-related disparities exist in the experience of delayed or forgone care. Conclusions: Children and their families are delaying or forgoing needed care due to health care-related financial burden. Policies are needed to effectively reduce financial burden and improve the concordance of insurance between parents and children because this may reduce the frequency of unmet need among families. Moreover, reducing the occurrence of delayed or forgone care may improve health outcomes by increasing the opportunity to receive timely and preventive care.

Everyday stresses and parenting

Article

Full-text available

Jan 2002

addresses issues central to an understanding of everyday stresses associated with parenthood / to provide a basis for the current state of research and theory, a discussion of the historical development of stress research is presented / the theoretical base for the importance of everyday stresses associated with parenting is provided in which the major issues related to such stress processes are set forth / these major issues include both the determinants of everyday stresses of parenting and the consequences ultimately associated with them / for both the determinants and the consequences, parent, child, and family factors are considered / the effectiveness of various parental coping mechanisms is discussed / concludes with an emphasis on the developmental salience of children's challenging behavior and the resilience that parents often demonstrate in the face of repetitive stresses (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Modeling the Impacts of Child Care Quality on Children's Preschool Cognitive Development

Article

Full-text available

Oct 2003
CHILD DEV

The National Institute of Child Health and Human Development (NICHD) Study of Early Child Care compared 3 statistical methods that adjust for family selection bias to test whether child care type and quality relate to cognitive and academic skills. The methods included: multiple regression models of 54-month outcomes, change models of differences in 24- and 54-month outcomes, and residualized change models of 54-month outcomes adjusting for the 24-month outcome. The study was unable to establish empirically which model best adjusted for selection and omitted-variable bias. Nevertheless, results suggested that child care quality predicted cognitive outcomes at 54 months, with effect sizes of .04 to .08 for both infant and preschool ages. Center care during preschool years also predicted outcomes across all models.

Context and Sequelae of Food Insecurity in Children's Development

Article

Full-text available

Oct 2010

The authors examined the role of food insecurity in the etiology of children's cognitive and mental health problems. Data from a prospective longitudinal study of 1,116 United Kingdom families with twins (sample constructed in 1999-2000) were used to test associations among household food insecurity; income; maternal personality; household sensitivity to children's needs; and children's cognitive, behavioral, and emotional development. Food-insecure children had lower IQs and higher levels of behavioral and emotional problems relative to their peers. After differences in household income, the personalities of children's mothers, and the sensitivity of household organization to children's needs were accounted for, food-insecure children had moderately higher levels of emotional problems relative to food-secure children (β = 0.22, P = 0.02). Differences in children's cognitive development were accounted for by household income, and differences in their behavioral development were accounted for by their mothers' personalities and their households' sensitivity to children's needs. Results suggest that food insecurity was associated with school-aged children's emotional problems but not with their cognitive or behavioral problems after accounting for differences in the home environments in which children were reared. Mothers' personality and household sensitivity to children's needs may present challenges to improving outcomes of children with food insecurity.

Economic Pressure in African American Families: A Replication and Extension of the Family Stress Model

Article

Full-text available

Mar 2002

This study of 422 two-caregiver African American families, each with a 10-11-year-old focal child (54% girls), evaluated the applicability of the family stress model of economic hardship for understanding economic influences on child development in this population. The findings generally replicated earlier research with European American families. The results showed that economic hardship positively relates to economic pressure in families. Economic pressure was related to the emotional distress of caregivers, which in turn was associated with problems in the caregiver relationship. These problems were related to disrupted parenting practices, which predicted lower positive child adjustment and higher internalizing and externalizing symptoms. The results provide significant support for the family stress model of economic hardship and its generalizability to diverse populations.

Household Food Insecurity is Associated With Adult Health Status

Article

Full-text available

Oct 2004

The prevalence of household food security, which reflects adequacy and stability of the food supply, has been measured periodically in the United States and occasionally in high-risk groups or specific regions. Despite a plausible biological mechanism to suggest negative health outcomes of food insecurity, this relation has not been adequately evaluated. This study was conducted in the Lower Mississippi Delta region to examine the association between household food insecurity and self-reported health status in adults. A two-stage stratified cluster sample representative of the population in 36 counties in the Delta region of Arkansas, Louisiana, and Mississippi was selected using list-assisted random digit dialing telephone methodology. After households were selected and screened, a randomly selected adult was interviewed within each sampled household. Data were collected to measure food security status and self-reported mental, physical, and general health status, using the U.S. Food Security Survey Module and the Short Form 12-item Health Survey (SF-12). Data were reported on a sample of 1488 households. Adults in food-insecure households were significantly more likely to rate their health as poor/fair and scored significantly lower on the physical and mental health scales of the SF-12. In regression models controlling for income, gender, and ethnicity, the interaction between food insecurity status and race was a significant predictor of fair/poor health and lower scores on physical and mental health. Household food insecurity is associated with poorer self-reported health status of adults in this rural, high-risk sample in the Lower Mississippi Delta.

Food Insecurity Affects School Children's Academic Performance, Weight Gain, and Social Skills1

Article

Full-text available

Dec 2005

Food insecurity has been associated with diverse developmental consequences for U.S. children primarily from cross-sectional studies. We used longitudinal data to investigate how food insecurity over time related to changes in reading and mathematics test performance, weight and BMI, and social skills in children. Data were from the Early Childhood Longitudinal Study-Kindergarten Cohort, a prospective sample of approximately 21,000 nationally representative children entering kindergarten in 1998 and followed through 3rd grade. Food insecurity was measured by parent interview using a modification of the USDA module in which households were classified as food insecure if they reported > or =1 affirmative response in the past year. Households were grouped into 4 categories based on the temporal occurrence of food insecurity in kindergarten and 3rd grade. Children's academic performance, height, and weight were assessed directly. Children's social skills were reported by teachers. Analyses examined the effects of modified food insecurity on changes in child outcomes using lagged, dynamic, and difference (i.e., fixed-effects) models and controlling for child and household contextual variables. In lagged models, food insecurity was predictive of poor developmental trajectories in children before controlling for other variables. Food insecurity thus serves as an important marker for identifying children who fare worse in terms of subsequent development. In all models with controls, food insecurity was associated with outcomes, and associations differed by gender. This study provides the strongest empirical evidence to date that food insecurity is linked to specific developmental consequences for children, and that these consequences may be both nutritional and nonnutritional.

Household Food Insecurity: Associations With At-Risk Infant and Toddler Development

Article

Full-text available

Feb 2008
Pediatrics

In this study, we evaluated the relationship between household food security status and developmental risk in young children, after controlling for potential confounding variables. The Children's Sentinel Nutritional Assessment Program interviewed (in English, Spanish, or Somali) 2010 caregivers from low-income households with children 4 to 36 months of age, at 5 pediatric clinic/emergency department sites (in Arkansas, Massachusetts, Maryland, Minnesota, and Pennsylvania). Interviews included demographic questions, the US Food Security Scale, and the Parents' Evaluations of Developmental Status. The target child from each household was weighed, and weight-for-age z score was calculated. Overall, 21% of the children lived in food-insecure households and 14% were developmentally "at risk" in the Parents' Evaluations of Developmental Status assessment. In logistic analyses controlling for interview site, child variables (gender, age, low birth weight, weight-for-age z score, and history of previous hospitalizations), and caregiver variables (age, US birth, education, employment, and depressive symptoms), caregivers in food-insecure households were two thirds more likely than caregivers in food-secure households to report that their children were at developmental risk. Controlling for established correlates of child development, 4- to 36-month-old children from low-income households with food insecurity are more likely than those from low-income households with food security to be at developmental risk. Public policies that ameliorate household food insecurity also may improve early child development and later school readiness.

Food Security During Infancy: Implications for Attachment and Mental Proficiency in Toddlerhood

Article

Full-text available

Apr 2008

This study examined the associations between household food security (access to sufficient, safe, and nutritious food) during infancy and attachment and mental proficiency in toddlerhood. Data from a longitudinal nationally representative sample of infants and toddlers (n = 8944) from the Early Childhood Longitudinal Study-9-month (2001-2002) and 24-month (2003-2004) surveys were used. Structural equation modeling was used to examine the direct and indirect associations between food insecurity at 9 months, and attachment and mental proficiency at 24 months. Food insecurity worked indirectly through depression and parenting practices to influence security of attachment and mental proficiency in toddlerhood. Social policies that address the adequacy and predictability of food supplies in families with infants have the potential to affect parental depression and parenting behavior, and thereby attachment and cognitive development at very early ages.

Promoting Food Security for All Children

Article

Nov 2015

This Policy Statement was reaffirmed March 2021 Sixteen million US children (21%) live in households without consistent access to adequate food. After multiple risk factors are considered, children who live in households that are food insecure, even at the lowest levels, are likely to be sick more often, recover from illness more slowly, and be hospitalized more frequently. Lack of adequate healthy food can impair a child’s ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems from preschool through adolescence. Food insecurity can affect children in any community, not only traditionally underserved ones. Pediatricians can play a central role in screening and identifying children at risk for food insecurity and in connecting families with needed community resources. Pediatricians should also advocate for federal and local policies that support access to adequate healthy food for an active and healthy life for all children and their families.

Associations Between Household Food Insecurity in Early Childhood and Children's Kindergarten Skills

Article

Mar 2017
CHILD DEV

Using nationally representative data on a recent birth cohort of U.S.-born children in low-income households (n = 2,800–3,700), this study investigates associations between the timing and intensity of early childhood food insecurity and children's kindergarten reading, math, and social-emotional outcomes. Descriptive patterns reveal that approximately 20% of low-income 0- to 5-year-old children reside in food-insecure households. Food insecurity experienced during early childhood is unfavorably associated with social-emotional outcomes in kindergarten, controlling for household income and prior assessments of child social-emotional skills. Results are less consistent for cognitive outcomes but similar in magnitude. If replicated, findings may inform policy efforts to reduce disparities in early skills for approximately 15 million U.S. children in food-insecure households.

Child Care and Child Development in the United States

Chapter

Feb 2017

Anna D. Johnson

In the last four decades, the number of young children who experience non-parental child care in the years leading up to school entry has surged. This dramatic increase in the number of children in various non-parental care types requires a new look at trends in who uses care, and what those children receive. This chapter defines the key terms and issues around early non-parental care and education, reviews the patterns and predictors of care use and key features of care that may influence child development, and then covers the empirical literature on how those features impact developmental outcomes. The chapter concludes with a brief discussion of future directions for child care research in the United States.

The conflict tactics scales and its critics: An evaluation of new data on validity and reliability

Article

Jan 1990

Poverty, Effects of on Social and Emotional Development

Article

Dec 2010

The prevalence of child and family poverty in the United States has sparked research around the negative associations between poverty and child development in families who cannot afford basic goods and services, such as food, clothing, and healthcare. More specifically, literature suggests that poverty hinders social and emotional development in children of all ages. The depth, persistence, and timing of poverty have a moderating role in the association between income and socio-emotional development. There are also many mechanisms through which poverty and its correlates impinge on early development: parents, the home environment, early education and care settings, and neighborhoods.

Poverty, Parenting, and Children's Mental Health

Article

Jun 1993

Poor children experience greater psychological distress than do nonpoor children. However, evidence for the relationship between poverty and children's distress is limited by the use of measures of poverty at a single point in time, by a failure to examine race or ethnic differences, and by a lack of concern with explanations for poverty's effects. Using data from the 1986 Children of the National Longitudinal Survey of Youth (NLSY) data set, we explored the relationships among current poverty, length of time spent in poverty, maternal parenting behaviors, and children's mental health. Persistent poverty significantly predicts children's internalizing symptoms above and beyond the effect of current poverty, whereas only current poverty predicts externalizing symptoms. Mother's weak emotional responsiveness and frequent use of physical punishment explain the effect of current poverty on mental health, but not the effect of persistent poverty. The relationships among poverty, parenting behaviors, and children's mental health do not vary by race/ethnicity. These findings support theoretical developments calling for greater emphasis on family processes in studies of children's poverty. They also argue for greater attention to trajectories of socioeconomic status in analyses of the effects of status on mental health.

Changes in Brain Weights during Span of Human Life - Relation of Brain Weights to Body Heights and Body Weights

Article

Oct 1978
ANN NEUROL

More than 20,000 autopsy reports from several general hospitals were surveyed for the purpose of selecting brains without a pathological lesion that had been weighed in the fresh condition. From this number, 2,773 males and 1,963 females were chosen for whom body weight, body height, and cause of death had been recorded. The data were segregated into 23 age groups ranging from birth to 86+ years and subjected to statistical evaluation. Overall, the brain weights in males were greater than in females by 9.8%. The largest increases in brain weights in both sexes occurred during the first 3 years of life, when the value quadruples over that at birth, while during the subsequent 15 years the brain weight barely quintuples over that at birth. Progressive decline in brain weight begins at about 45 to 50 years of age and reaches its lowest values after age 86 years, by which time the mean brain weight has decreased by about 11% relative to the maximum brain weight attained in young adults (about 19 years of age). Computed regression lines for brain weights versus body heights and body weights and for ratios of brain weights to body heights and weights versus age groups show clearly differential rates of change in brain weights which are less affected by sex.

Food Insufficiency and Depression

Article

Dec 2005

Using National Population Health Survey data and the stress process model, this study investigates the relationship between food insufficiency and the risk of depression among Canadian adults. The study presents three principal findings. First, after controlling for conventional socioeconomic and socio-demographic variables, food insufficiency increases the risk of depression and actually predicts this risk better than measures of low income, main source of income, and education. Second, the negative effect of food insufficiency is not attributable to social resources disparities, even though these resources significantly reduce the size of the effect. Third, the effects of food insufficiency on depression are generally stronger for women than for men, but the results also indicate that single fathers from food insufficient households face more depression than other groups, including single mothers. © 2006 by Pacific Sociological Association. All rights reserved.

Household food insecurity and children's school engagement

Article

Mar 2005

Godwin Ashiabi

Data on 11,614 children (ages 6-11) from the 1999 National Survey of American Families were used to examine a model linking household food insecurity, child health, and emotional well-being to school engagement. The results, using path analyses revealed that (i) the proposed model fit the data quite well; (ii) food insecurity predicted health status, emotional well-being, and negatively predicted school engagement; (iii) health status predicted emotional well-being, and negatively predicted school engagement. Finally, emotional well-being negatively predicted school engagement. Results of mediation analyses showed that food insecurity had a significant indirect effect on emotional well-being via its effect on health status, and a significant indirect effect on school engagement via its effects on health status and emotional well-being.

The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

Article

Jun 1977
APPL PSYCH MEAS

Lenore Sawyer Radloff

The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.

Racial, Ethnic, Socioeconomic, and Access Disparities in the Use of Preventive Services among Women

Article

Nov 2003

In this article we estimate the variations in receipt of age-appropriate preventive services among adult women between 21 and 64 years of age, by race and ethnic group, socioeconomic status, and access to health care. We also assess whether differences in access to care and socioeconomic status may explain racial and ethnic differences in the use of preventive services. Nationally representative data on adult women from the Medical Expenditure Panel Survey were used to estimate the effect of socioeconomic characteristics on the receipt of each preventive service. Receipt of each of four preventive services-cholesterol test, blood pressure reading, and two cancer screening tests (Papanicolaou smear, mammogram)-according to the 1996 recommendations of the U.S. Preventive Services Task Force were examined. An overwhelming majority of adult women (93%) had had a blood pressure reading within the last 2 years. Eighty-four percent of women had had their cholesterol checked within the last 5 years. Seventy-five percent of women had received a mammogram and 80% received Pap tests. College education, high income, usual source of care, and health insurance consistently predicted use of preventive services. These factors also explained ethnic disparities in the receipt of preventive services between Latinas and white women. The results from our study are encouraging because only a minority of women do not receive age-appropriate preventive services. However, low socioeconomic status, lack of insurance, and lack of a usual source of care represent significant barriers to preventive care for adult women.

The World Health Organization Composite International Diagnostic Interview Short-form (CIDI-SF)

Article

Nov 1998

Data are reported on a series of short-form (SF) screening scales of DSM-III-R psychiatric disorders developed from the World Health Organization's Composite International Diagnostic Interview (CIDI). A multi-step procedure was used to generate CIDI-SF screening scales for each of eight DSM disorders from the US National Comorbidity Survey (NCS). This procedure began with the subsample of respondents who endorsed the CIDI diagnostic stem question for a given disorder and then used a series of stepwise regression analyses to select a subset of screening questions to maximize reproduction of the full CIDI diagnosis. A small number of screening questions, between three and eight for each disorder, was found to account for the significant associations between symptom ratings and CIDI diagnoses. Summary scales made up of these symptom questions correctly classify between 77% and 100% of CIDI cases and between 94% and 99% of CIDI non-cases in the NCS depending on the diagnosis. Overall classification accuracy ranged from a low of 93% for major depressive episode to a high of over 99% for generalized anxiety disorder. Pilot testing in a nationally representative telephone survey found that the full set of CIDI-SF scales can be administered in an average of seven minutes compared to over an hour for the full CIDI. The results are quite encouraging in suggesting that diagnostic classifications made in the full CIDI can be reproduced with excellent accuracy with the CIDI-SF scales. Independent verification of this reproduction accuracy, however, is needed in a data set other than the one in which the CIDI-SF was developed. Copyright © 1998 Whurr Publishers Ltd.

Maternal Depression: A Global Threat to Children’s Health, Development, and Behavior and to Human Rights

Article

Apr 2009
CHILD DEV PERSPECT

ABSTRACT—Depressive disorders are a common source of disability among women. In addition to the economic and human costs of maternal depression, children of depressed mothers are at risk for health, developmental, and behavioral problems. Although most of the research examining the evidence and intergenerational aspects of maternal depression has been conducted in high-income countries, recent evidence suggests that rates of maternal depression may be higher in low- and middle-income countries, where nearly 90% of the world’s children live. This review examines the evidence from low- and middle-income countries that links maternal depression with children’s health, development, and behavior. We present recommendations for future policies and intervention programs related to maternal depression and examine how maternal depression affects the rights of millions of children living in these countries.

Cumulative parenting stress across the preschool period: Relations to maternal parenting and child behaviour at age 5

Article

Jun 2005
INFANT CHILD DEV

Despite increasing interest in the effects of parenting stress on children and families, many questions remain regarding the nature of parenting stress and the mechanism through which stress exerts its influence across time. In this study, cumulative parenting stress was assessed across the preschool period in a sample of 125 typically developing children and their mothers. Indices of parenting stress included both major life events stress-assessed annually from age 3 to 5, and parenting daily hassles assessed every 6 months across the same period. Naturalistic home observations were conducted when children were age 5, during which measures of parent and child interactive behaviour as well as dyadic pleasure and dyadic conflict were obtained. Mothers also completed the CBCL to assess children's behaviour problems. Results indicated that parenting daily hassles and major life stress are relatively stable across the preschool period. Both cumulative stress indices also proved to be important predictors of parent and child behaviour and dyadic interaction, although the predictions were somewhat differential. Despite meaningful relations between the stress factors and child well being, no evidence was found to support the premise that parent behaviour mediates the association between parenting stress and child outcomes. Results are discussed within a developmental framework to understand the stability and complexity of cumulative stress associations to early parent–child relationships. Copyright © 2005 John Wiley & Sons, Ltd.

Maternal Depression in the United States: Nationally Representative Rates and Risks

Article

Aug 2011
J WOMENS HEALTH

To examine the public health burden of major depressive disorder (MDD) among mothers: its prevalence and sociodemographic patterns; associated functioning, comorbidities, and adversities; and racial/ethnic disparities. This was a cross-sectional analysis of 8916 mothers in the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative survey of the civilian U.S. population in 2001?2002. Past-year MDD was assessed with a structured interview protocol. Ten percent of mothers experienced depression in the past year. White and Native American women, those with low education or income, and those not married had high rates of depression. Depression was not strongly patterned by number of or age of children. Depressed mothers experienced more adversities (poverty, separation or divorce, unemployment, financial difficulties) and had worse functioning. Half of depressed mothers received services for their depression. Black and Hispanic depressed mothers were more likely to experience multiple adversities and less likely to receive services than white depressed mothers. Maternal depression is a major public health problem in the United States, with an estimated 1 in 10 children experiencing a depressed mother in any given year. Professionals who work with mothers and children should be aware of its prevalence and its detrimental effects.

Transitions between food insecurity and food security predict children's social skill development during elementary school

Article

Jun 2011
BRIT J NUTR

Larry L. Howard

Recent findings indicate that household food insecurity affects children's social skill development in the early years of elementary school. It is important to assess the persistency of developmental consequences and investigate whether all categories of social skills are equally affected by food insecurity experiences. The present paper estimates population-averaged and subject-specific models for children's social skill scores reported by school teachers using longitudinal data on 2310 boys and 2400 girls in the USA enrolled in the 1st (aged 6-9 years), 3rd (aged 8-11 years) and 5th (aged 10-13 years) grades (1999-2003) from the Early Childhood Longitudinal Study-Kindergarten. The main findings are, first, significantly (P < 0·05) negative, contemporaneous and transitional relationships between food insecurity experiences and children's social skill scores are evident. Estimates based on sex-stratified samples indicate that the contemporaneous association is strongest among girls, while the association of an early transition from food insecurity in the 1st grade to food security in the 3rd grade is strongest among boys. Second, food insecurity experiences predict children's social skill scores emphasising self-control, attentiveness and task persistence, rather than interpersonal relationships or externalising behaviour. Overall, the findings underscore the multifaceted effect that household food insecurity has on children's social skills and provide the strongest empirical evidence to date that the experiences are linked with non-nutritional developmental consequences for children over a time horizon spanning several years.

Poverty, Food Insecurity, and the Behavior for Childhood Internalizing and Externalizing Disorders

Article

May 2010

This study investigated the associations of poverty and food insecurity over a 2-year period with internalizing and externalizing problems in a large, community-based sample. A total of 2,810 children were interviewed between ages 4 and 14 years at baseline, and between ages 5 and 16 years at follow-up. Primary caregivers reported on household income, food insecurity, and were administered the Child Behavior Checklist, from which we derived indicators of clinically significant internalizing and externalizing problems. Prevalence ratios for the associations of poverty and food insecurity with behavior problems were estimated. At baseline, internalizing and externalizing problems were significantly more prevalent among children who lived in poor households than in nonpoor households, and among children who lived in food insecure households than in food-secure households. In adjusted analyses, children from homes that were persistently food insecure were 1.47 (95% CI = 1.12 to 1.94) times more likely to have internalizing problems and 2.01 (95% CI = 1.21 to 3.35) times more likely to have externalizing problems compared with children from households that were never food insecure. Children from homes that moved from food secure to insecure were 1.78 (95% CI = 1.07 to 2.94) times more likely to have externalizing problems at follow-up. Persistent food insecurity is associated with internalizing and externalizing problems, even after adjusting for sustained poverty and other potential confounders. These results implicate food insecurity as a novel risk factor for child mental well-being; if causal, this represents an important factor in the etiology of child psychopathology, and potentially a new avenue for prevention.

Mental Health Context of Food Insecurity: a Representative Cohort of Families With Young Children

Article

Oct 2009
Pediatrics

Children from food-insecure families (ie, families that lack access to sufficient, safe, and nutritious food) are at risk for developmental problems. Food insecurity disproportionately occurs among low-socioeconomic status (SES) and low-income families; however, interventions that supplement families' income or diet have not eradicated food insecurity. This may be because food insecurity is also related to nonfinancial factors such as the presence of maternal mental health problems. To clarify whether addressing mothers' mental health problems may be a promising strategy for reducing the burden of food insecurity, we tested the hypothesis that low-SES families are especially vulnerable to food insecurity when the mother experiences depression, alcohol or drug abuse, psychosis spectrum disorder, or domestic violence. We used data from a nationally representative cohort of 1116 British families (the Environmental Risk Longitudinal Study). Food insecurity, family SES, maternal mental health and exposure to domestic violence, and children's behavioral outcomes were measured by using validated methods. Overall, 9.7% of study families were food-insecure. Among low-SES families, controlling for income variation, food insecurity co-occurred with maternal depression (odds ratio [OR]: 2.82 [95% confidence interval (CI): 1.62-4.93]), psychosis spectrum disorder (OR: 4.01 [95% CI: 2.03-7.94]), and domestic violence (OR: 2.36 [95% CI: 1.18-4.73]). In addition, food insecurity predicted elevated rates of children's behavior problems. Among families with young children, food insecurity is frequent, particularly when the mother experiences mental health problems. This suggests that interventions that improve women's mental health may also contribute to decreasing the burden of food insecurity and its impact on the next generation.

Brain iron: A lesson from animal models

Article

Oct 1989

Brain and blood iron deficiency (ID) can be nutritionally induced. Significant behavioral and brain-biochemical changes are observed in rats rendered iron deficient, including complete reversal of the circadian cycles of motor activity, changes in thermoregulation and stereotyped behavior, and an increased pain threshold. The increase in pain threshold is affected by diurnal factors and peripheral treatment with beta-endorphin has a significant analgesic effect, implicating selective changes in the blood-brain barrier. These effects along with modifications in responses to dopaminergic drugs, interactions of ID with neuroleptic drugs, and modifications in behavior as a result of selective brain lesions, lead to two conclusions: this animal model is appropriate for human anemia and the best explanation for the variety of behavioral and brain biochemical changes in ID rats is that the principal effect of brain ID is a selective decrease in the functional level of the dopaminergic D2 system.

The Effects of Varying Environmental Demands on Maternal and Infant Behavior

Article

Mar 1984

3 groups of macaque mother-infant dyads were observed while each lived in ecological settings that differed in their level of foraging demand and, hence, the amount of work each mother was required to perform to obtain her daily rations. 2 groups (LFD and HFD) lived in stable low- and high-demand environments, respectively. The third group (VFD) lived in a variable-demand environment in which 2-week periods of HFD and LFD conditions were alternated, without external cues. Observations suggested that VFD subjects were unable to predict or rapidly adapt to the biweekly changes in food availability. Whereas LFD adults scored lowest in dominance-related behaviors and highest in affiliative behavior (social grooming), VFD adults showed the highest levels of dominance patterns and the lowest levels of grooming. VFD infants showed the most sustained clinging to mother, the lowest levels of social play and exploration, the highest levels of affective disturbance, and repeated evidence of depression as the study progressed. These findings suggest that in monkeys, as in humans, when, because of competing demands, mothers are psychologically unavailable to their infants, attachments are less secure, normal development is disrupted, and psychopathological patterns are more likely to emerge.

Nutritional and Health Consequences Are Associated with Food Insecurity among U.S. Elderly Persons

Article

Jun 2001

The purpose of this study was to examine the consequences associated with food insecurity for the nutritional and health status of the elderly in the United STATES: The data analyzed were from the Third National Health and Nutrition Examination Survey (1988-1994) and the Nutrition Survey of the Elderly in New York State (1994). Multiple logistic and linear regression analyses were used to assess the extent to which food-insecure elderly were likely to have lower nutrient intake, skinfold thickness, self-reported health status and higher nutritional risk. Regardless of food insecurity status, older people consumed less than the recommended dietary allowance for eight nutrients. Food-insecure elderly persons had significantly lower intakes of energy, protein, carbohydrate, saturated fat, niacin, riboflavin, vitamins B-6 and B-12, magnesium, iron and zinc, as well as lower skinfold thickness. In addition, food-insecure elderly persons were 2.33 (95% confidence interval: 1.73-3.14) times more likely to report fair/poor health status and had higher nutritional risk. These results indicate that food-insecure elderly persons have poorer dietary intake, nutritional status and health status than do food-secure elderly persons. It is necessary to ensure the nutritional well-being of all elderly persons who are at nutritional and health risk, including those who are food insecure and have even poorer nutritional and health status than those who are food secure.

Food Insufficiency and American School-Aged Children's Cognitive, Academic, and Psychosocial Development

Article

Aug 2001
Pediatrics

This study investigates associations between food insufficiency and cognitive, academic, and psychosocial outcomes for US children and teenagers ages 6 to 11 and 12 to 16 years. Data from the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed. Children were classified as food-insufficient if the family respondent reported that his or her family sometimes or often did not get enough food to eat. Regression analyses were conducted to test for associations between food insufficiency and cognitive, academic, and psychosocial measures in general and then within lower-risk and higher-risk groups. Regression coefficients and odds ratios for food insufficiency are reported, adjusted for poverty status and other potential confounding factors. After adjusting for confounding variables, 6- to 11-year-old food-insufficient children had significantly lower arithmetic scores and were more likely to have repeated a grade, have seen a psychologist, and have had difficulty getting along with other children. Food-insufficient teenagers were more likely to have seen a psychologist, have been suspended from school, and have had difficulty getting along with other children. Further analyses divided children into lower-risk and higher-risk groups. The associations between food insufficiency and children's outcomes varied by level of risk. The results demonstrate that negative academic and psychosocial outcomes are associated with family-level food insufficiency and provide support for public health efforts to increase the food security of American families.

Income, family characteristics, and physical violence toward children

Article

Mar 2005
CHILD ABUSE NEGLECT

Lawrence M Berger

This paper discusses the ways in which existing microeconomic theories of partner abuse, intra-family bargaining, and distribution of resources within families may contribute to our current understanding of physical child abuse. The empirical implications of this discussion are then tested on data from the 1985 National Family Violence Survey (NFVS) in order to estimate the effects of income, family characteristics, and state characteristics on physical violence toward children. The sample consists of 2,760 families with children from the NFVS. Probit and ordered probit models are used to explore relationships between income, family characteristics, state characteristics, and physical violence toward children among single-parent and two-parent families. In both single-parent and two-parent families, depression, maternal alcohol consumption, and history of family violence affect children's probabilities of being abused. Additionally, income is significantly related to violence toward children in single-parent families. These results reinforce earlier findings that demographic characteristics, maternal depression, maternal alcohol use, and intra-family patterns of violence may largely contribute to child abuse. This research also suggests that income may play a substantially more important role in regard to parental violence in single-parent families than in two-parent families.

Validity of a 12-item version of the CES-D used in the National Longitudinal Study of Children and Youth

Article

Mar 2005

This validation study assessed the degree of confidence that can be placed on inferences from depressive symptoms among adolescents, based on a 12-item version of the Centre for Epidemiological Studies Depression scale (CES-D). This short version of the scale had been developed for application in the National Longitudinal Study of Children and Youth and we refer to it as the CES-D-12-NLSCY. The major data source for the present validation study was a 2002/2003 survey of 12,990 students in junior and senior high school in the Atlantic provinces of Canada. Receiver operating characteristic curve analyses for two different proxy gold standards yielded adequate areas under the curve (AUCs) of .84 and .80, allowing us to establish cut points for three categories of depressive symptoms in the general adolescent population: Minimal (CES-D-12-NLSCY total score 0 to 11), Somewhat Elevated (total score 12 to 20) and Very Elevated (total score 21 to 36). The CES-D-12-NLSCY was found to have acceptable internal consistency (Cronbach=s alpha .85). All but one of the 12 items of the CES-D-12-NLSCY were found to have acceptable discrimination ability. The prevalence of Minimal, Somewhat and Very Elevated depressive symptoms in the adolescent student population of the Atlantic provinces was estimated to be 72.3, 19.5 and 5.5 percent, respectively. A further 2.6 percent of students who responded to fewer than 11 items of the scale were classified as Indeterminate with regards to depressive symptom category. The major threat to the accuracy of the CES-D-12-NLSCY is its lack of inquiry about irritability, which is a key symptom of depression in youth.

Economic, Neurobiological, and Behavioral Perspectives on Building America's Future Workforce

Article

Aug 2006

A growing proportion of the U.S. workforce will have been raised in disadvantaged environments that are associated with relatively high proportions of individuals with diminished cognitive and social skills. A cross-disciplinary examination of research in economics, developmental psychology, and neurobiology reveals a striking convergence on a set of common principles that account for the potent effects of early environment on the capacity for human skill development. Central to these principles are the findings that early experiences have a uniquely powerful influence on the development of cognitive and social skills and on brain architecture and neurochemistry, that both skill development and brain maturation are hierarchical processes in which higher level functions depend on, and build on, lower level functions, and that the capacity for change in the foundations of human skill development and neural circuitry is highest earlier in life and decreases over time. These findings lead to the conclusion that the most efficient strategy for strengthening the future workforce, both economically and neurobiologically, and improving its quality of life is to invest in the environments of disadvantaged children during the early childhood years. • child development • early experience • economic productivity • critical and sensitive periods • brain development

Why Lower Income Mothers Do Not Engage With the Formal Mental Health Care System: Perceived Barriers to Care

Article

Oct 2006

Lower income mothers who bring their children for mental health services also have high rates of depression and anxiety, yet few seek help. Maternal and child mental health are intimately intertwined; thus, the distress of both is likely to continue if the mother's needs are unaddressed. Because mothers overcome numerous instrumental challenges to help their children, the authors identify potential perceptual barriers to mothers' help seeking. An ethnographic analysis of in-depth qualitative interviews with 127 distressed mothers suggests several critical perceptual factors. For example, mothers attributed their distress to external causes (e.g., poverty, negative life stressors), which they believed individually focused mental health services could not affect. Interviewees also anticipated negative ramifications for seeking care, including being labeled unfit mothers, and thus potentially losing custody of their children. The authors discuss the implications of these and other key themes for engaging lower income mothers and their children.

Food Insecurity and the Risks of Depression and Anxiety in Mothers and Behavior Problems in their Preschool-Aged Children

Article

Sep 2006
Pediatrics

We sought to determine if the prevalence of depression and anxiety in mothers and the prevalence of behavior problems in preschool-aged children are more common when mothers report being food insecure. A cross-sectional survey of 2870 mothers of 3-year-old children was conducted in 2001-2003 in 18 large US cities. On the basis of the adult food-security scale calculated from the US Household Food Security Survey Module, mothers were categorized into 3 levels: fully food secure, marginally food secure, and food insecure. The 12-month prevalence in mothers of a major depressive episode and generalized anxiety disorder was assessed by the Composite International Diagnostic Interview-Short Form. A child behavior problem in > or = 1 of 3 domains (aggressive, anxious/depressed, or inattention/hyperactivity) was based on the Child Behavior Checklist. Seventy-one percent of the respondents were fully food secure, 17% were marginally food secure, and 12% were food insecure. After adjustment for sociodemographic factors plus maternal physical health, alcohol use, drug use, prenatal smoking, and prenatal physical domestic violence, the percentage of mothers with either major depressive episode or generalized anxiety disorder increased with increasing food insecurity: 16.9%, 21.0%, and 30.3% across the 3 levels. Among children, after further adjustment for maternal major depressive episode and generalized anxiety disorder, the percentage with a behavior problem also increased with increasing food insecurity: 22.7%, 31.1%, and 36.7%. Mental health problems in mothers and children are more common when mothers are food insecure, a stressor that can potentially be addressed by social policy.

Income Is Not Enough: Incorporating Material Hardship Into Models of Income Associations With Parenting and Child Development

Article

Feb 2007

Although research has clearly established that low family income has negative impacts on children's cognitive skills and social-emotional competence, less often is a family's experience of material hardship considered. Using the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (N=21,255), this study examined dual components of family income and material hardship along with parent mediators of stress, positive parenting, and investment as predictors of 6-year-old children's cognitive skills and social-emotional competence. Support was found for a model that i

Food Insecurity and Family Well-Being Outcomes among Households with Young Children

Abstract

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