Disentangling food insecurity and maternal depression: which comes first?

Abstract

Objective: To determine the temporal directionality of the association between food insecurity and maternal depression. Design: Food insecurity was measured at two time points using the 18-item USDA Food Security Scale. Maternal depression was measured at two time points using the 15-item Composite International Diagnostic Interview-Short Form. Two structural equation models were utilized to evaluate the impact of food insecurity on maternal depression (model 1) and the impact of maternal depression on food insecurity (model 2). Both models controlled for socio-demographic and parenting characteristics and child behavior problems, along with prior measures of the dependent variable, concurrent measures of the independent variable. Setting: Fragile Families and Child Wellbeing (FFCW) study, 20 cities across the United States Participants: 4,897 mothers who participated in two waves of the FFCW study. Results: On average, 17% (time 1) and 15% (time 2) of mothers experienced food insecurity and 21% (time 1) and 17% (time 2) of mothers experienced depression over time. Maternal depression at time 1 was associated with 53% increased odds (OR=1.53; B=0.43; p <.001) of food insecurity at time 2, controlling for time 1 food insecurity, concurrent depression, and covariates. Food insecurity at time 1 was associated with 36% increased odds (OR=1.36; B=0.31; p <.001) of maternal depression at time 2, controlling for time 1 depression, concurrent food insecurity, and covariates. Conclusions: We found a bidirectional relationship between food insecurity and maternal depression. A holistic approach that combines food assistance and mental health services may be an efficacious approach to reducing both depressive symptoms food insecurity among low-income mothers.

Household food insecurity and early childhood development in Brazil: an analysis of children under 2 years of age

“…motor skills enable the child to interact with the environment and this interaction is required by the child to develop proper language skills (43) . Second, HFI can compromise parental well-being, including maternal mental health (7,(44)(45)(46) , and interferes with parent-child interactions and the emotional environment at home (47,48) , which may lead to delays in ECD due to poor interaction between child and caregivers (7,8) . In summary, the nutrition-and psycho-emotional stress related to HFI may lead to a lack of responsive and stimulating care by caregivers (37,49) , limiting early stimulation and learning opportunities needed for proper child development, including activities such as talking to children, telling stories, playing and well-supervised explorations of environments outside the home (50) .…”

A latent class analysis to identify socio-economic and health risk profiles among mothers of young children predicting longitudinal risk of food insecurity

“…Related, mothers in Class 1 report greater material hardships compared to mothers in Class 4, even though Class 1 mothers had several protective socio-economic factors: higher percent of mothers with income 200–299% of the FPL (working poor), educated and employed. Material hardships, partner incarceration, depressive/anxious symptoms, and substance use have been independently linked to lower food insecurity risk [ 9 , 29 , 31 , 34 , 37 ]. Even though the mothers in high employment hardship and low-income class (Class 4) were similar to Classes 1, 2 and 3 in poverty, mothers in Class 4 were more likely to report being married or cohabitating and engaged in a higher use of WIC, which may also explain their lower risk of food insecurity compared to mothers in other high-risk classes [ 59 , 68 ].…”

“…This finding concurs with the Healthy Immigrant Effect, where immigrants display better health than individuals from host country [ 69 ]. Prior research has shown that poor health and substance use behaviors may limit mother’s financial stability and the ability to maintain steady employment [ 70 ] placing the family at risk of experiencing food insecurity and other material hardships [ 9 , 37 , 71 ].…”

“…Research using variable-centered regression models have identified multiple maternal and household characteristics as independent predictors of food insecurity. Among households with children, maternal characteristics associated with greater risk for food insecurity include older age [ 22 , 23 ], racial/ethnic minority status [ 24 , 25 ], immigrant status [ 26 ], cohabitating, re-partnered or single marital status [ 1 , 27 ], lower levels of education [ 28 – 30 ], unemployment [ 14 , 31 ], poor mental and physical health [ 9 , 25 , 29 , 32 , 33 ], and substance use [ 34 ]. Household characteristics including poverty/lower income [ 14 , 30 ], parental incarceration [ 31 , 35 ], multi-generational households [ 36 ], and household material hardships [ 37 – 39 ] are associated with higher risk of food insecurity.…”

Does a food insecurity intervention improve perinatal outcomes for mother and child? A randomized control study protocol of the Fresh Rx: Nourishing Healthy Starts program

“…12,13 Additionally, stress, depression, and anxiety are more common among food insecure mothers, 14,15 and research has suggested a bidirectional relationship between maternal depression and food insecurity. 16…”