Food insecurity and housing instability during early childhood as predictors of adolescent mental health.

Abstract

This study examined the effects of food insecurity and housing instability experiences during early childhood on adolescent anxiety and depressive symptoms through maternal depression and parenting stress. This longitudinal study included 4 waves of data from the Fragile Families and Child Well-Being Study (n ϭ 2,626). Food insecurity was measured when the child was 5 years of age using the U.S. Department of Agriculture's 18-item Food Security Scale. Housing instability was also measured when the child was 5 years of age based on an affirmative response to 6 housing adversity items. Maternal depression and parenting stress were measured when the child was 9 years of age. Anxiety and depressive symptoms were assessed when the child (now adolescent) was 15 years of age using 6 items of the Brief Symptom Inventory 18 anxiety subscale and 5 items of the Centers for Epidemiologic Studies Depression Scale, respectively. Two structural equation models assessed the associations between food insecurity and housing instability on adolescent anxiety (Model 1) and depressive symptoms (Model 2) through maternal depression and parenting stress simultaneously, controlling for sociodemographic characteristics. Results suggest that experiencing both food insecurity and housing instability during early childhood increases the risk of long-term adolescent depressive (indirect: B ϭ 0.008, 95% CI [0.002, 0.016]) and anxiety (indirect: B ϭ 0.012, 95% CI [0.002, 0.026]) symptoms through maternal depression to parenting stress. Screening for food insecurity and housing instability during early childhood could potentially identify both mothers who are at risk for depression and parenting stress and children who are at increased risk for anxiety or depressive symptoms during adolescence.

Economic hardship and child intake of foods high in saturated fats and added sugars: the mediating role of parenting stress among high-risk families

“…This study represents a first step in expanding beyond incomeonly indicators of hardship. In addition to the supports families may need to address specific forms of hardship (e.g., housing supports, food supports and medical care), results of this study, similar to other studies (94) , suggest that screening for various multiple hardships may provide opportunities to determine when parents also need supports to cope with feelings of stress associated with the experience of parenting in the context of EH. Coping and resilience are major factors in shaping how stress under such circumstances is handled (95) .…”

Longitudinal Trajectories of Food Insecurity in Childhood and Their Associations With Mental Health and Functioning in Adolescence

“…To our knowledge, other studies of food insecurity and ADHD in youths have been cross-sectional, 8 and most have relied on maternal reports of ADHD. Maternal ratings of ADHD may be influenced by parental distress, 39 , 40 , 41 which may be associated with food insecurity, 42 , 43 thus possibly inflating observed associations between food insecurity and ADHD. In the current investigation, the use of adolescent ratings probably mitigated the association of parental distress with outcome measurements.…”

Toward Measurement for a Whole Child Health Policy: Validity and National and State Prevalence of the Integrated Child Risk Index

“…41,42 The Medical Health Risk (MHR) domain includes four measures that identify children experiencing: (1) a more complex special health care need based on responses to the validated CSHCN Screener; 56 (2) two or more of the chronic or life-long diagnosed conditions asked about in the NSCH; 57 (3) one or more of eleven frequent, chronic and/or serious functional difficulties aligned with domains included in the International Classification of Functioning for Children and Youth; 58 and (4) fair or poor overall health status. 59 The Social Health Risk (SHR) domain includes four measures that identify children whose caregivers reported that they: (1) sometimes or often could not afford enough food to eat; 10,11 (2) somewhat often or very often found it hard to cover the costs of basics needs, including housing; 29,30 (3) lived in an unsafe neighborhood or where the child was a victim of or witnessed violence; 13,39 and (4) witnessed their child being treated or judged unfairly due to his or her race or ethnic group. 14,31 The Relational Health Risk (RHR) domain includes four measures that identify children based on risks to the safety, stability and nurturing qualities of their relationships in the home.…”

“…[1][2][3][4][5][6][7] If nothing else, the disparities in morbidity and mortality unveiled by the pandemic confirm what our best science has told us for decades: physical and mental health do not occur in a vacuum and are strongly impacted by social inequities and the toxic stress and trauma that can arise in the presence of relational risks. 2,[7][8][9] Socially, children must have basic needs met, like food, 10,11 safe housing, 11,12 and neighborhoods free from violence 13 and racism. 14 Relationally, healthy development requires the presence of safe, stable and nurturing relationships across all contexts where children learn, play and grow.…”

“…Predominant medical cost-driven and diagnostic-based methods typically do not account for the mitigatable community-level social health risks (SHR) that pose threats to children's health (e.g., poverty, 2,,29,30 food insecurity, 10,11 exposure to community violence 13 or racism 14,31 ) or the familylevel relational health risks (RHR) that threaten children's well-being (e.g., Adverse Childhood Experiences [ACEs ] 1-3,7,9, [15][16][17][18][19][20]32,33 or caregivers who lack support or are distressed). 3,4,34,35 With the exception of interpersonal safety, a recent review of evidence on social risks screening and interventions conducted for the US Preventive Services Task Force (USPTF) limited the concept of social risks to income-associated factors.…”