OBJECTIVES: To examine how family stressors (household food insecurity and/or caregiver depressive symptoms) relate to child health and whether participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) attenuates stress-related child health risks. DESIGN: Cross-sectional family stress and cumulative stress models from January 1, 2000, through December 31, 2010. SETTING: Families recruited from emergency departments and/or primary care in Baltimore, Boston, Little Rock, Los Angeles, Minneapolis, Philadelphia, and Washington, DC. PARTICIPANTS: Participants included 26,950 WIC-eligible caregivers and children younger than 36 months; 55.2% were black, 29.9% were Hispanic, and 13.0% were white. Caregivers' mean age was 25.6 years; 68.6% were US-born, 64.7% had completed high school, 38.0% were married, and 36.5% were employed. MAIN EXPOSURES: Of the participants, 24.0% had household food insecurity and 24.4% had depressive symptoms; 9.1% had both stressors, 29.9% had 1 stressor, and 61.0% had neither; 89.7% were WIC participants. OUTCOME MEASURES: Caregivers reported child health, lifetime hospitalizations, and developmental risk. Weight and length were measured. We calculated weight-for-age and length-for-age z scores and the risk of underweight or overweight. The well-child composite comprised good/excellent health, no hospitalizations, no developmental risk, and neither underweight nor overweight. RESULTS: In multivariate analyses adjusted for covariates, as stressors increased, odds of fair/poor health, hospitalizations, and developmental risk increased and odds of well-child status decreased. Interactions between WIC participation and stressors favored WIC participants over nonparticipants in dual stressor families on 3 child health indicators: (1) fair/poor health: WIC participants, adjusted odds ratio (aOR), 1.89 (95% CI, 1.66-2.14) vs nonparticipants, 2.35 (2.16-4.02); (2) well-child status: WIC participants, 0.73 (0.62-0.84) vs nonparticipants, 0.34 (0.21-0.54); and (3) overweight: WIC participants, 1.01 (0.88-1.16) vs nonparticipants, 1.48 (1.04-2.11) (P = .06). CONCLUSIONS: As stressors increased, child health risks increased. WIC participation attenuates but does not eliminate child health risks.
OBJECTIVES: To examine how family stressors (household food insecurity and/or caregiver depressive symptoms) relate to child health and whether participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) attenuates stress-related child health risks. DESIGN: Cross-sectional family stress and cumulative stress models from January 1, 2000, through December 31, 2010. SETTING: Families recruited from emergency departments and/or primary care in Baltimore, Boston, Little Rock, Los Angeles, Minneapolis, Philadelphia, and Washington, DC. PARTICIPANTS: Participants included 26,950 WIC-eligible caregivers and children younger than 36 months; 55.2% were black, 29.9% were Hispanic, and 13.0% were white. Caregivers' mean age was 25.6 years; 68.6% were US-born, 64.7% had completed high school, 38.0% were married, and 36.5% were employed. MAIN EXPOSURES: Of the participants, 24.0% had household food insecurity and 24.4% had depressive symptoms; 9.1% had both stressors, 29.9% had 1 stressor, and 61.0% had neither; 89.7% were WIC participants. OUTCOME MEASURES: Caregivers reported child health, lifetime hospitalizations, and developmental risk. Weight and length were measured. We calculated weight-for-age and length-for-age z scores and the risk of underweight or overweight. The well-child composite comprised good/excellent health, no hospitalizations, no developmental risk, and neither underweight nor overweight. RESULTS: In multivariate analyses adjusted for covariates, as stressors increased, odds of fair/poor health, hospitalizations, and developmental risk increased and odds of well-child status decreased. Interactions between WIC participation and stressors favored WIC participants over nonparticipants in dual stressor families on 3 child health indicators: (1) fair/poor health: WIC participants, adjusted odds ratio (aOR), 1.89 (95% CI, 1.66-2.14) vs nonparticipants, 2.35 (2.16-4.02); (2) well-child status: WIC participants, 0.73 (0.62-0.84) vs nonparticipants, 0.34 (0.21-0.54); and (3) overweight: WIC participants, 1.01 (0.88-1.16) vs nonparticipants, 1.48 (1.04-2.11) (P = .06). CONCLUSIONS: As stressors increased, child health risks increased. WIC participation attenuates but does not eliminate child health risks.
Authors: Lauren B Covington; Valerie E Rogers; Bridget Armstrong; Carla L Storr; Maureen M Black Journal: J Clin Sleep Med Date: 2019-06-15 Impact factor: 4.062
Authors: Kristen M Hurley; M Reese Pepper; Margo Candelaria; Yan Wang; Laura E Caulfield; Laura Latta; Erin R Hager; Maureen M Black Journal: J Nutr Date: 2013-09-25 Impact factor: 4.798
Authors: John T Cook; Maureen Black; Mariana Chilton; Diana Cutts; Stephanie Ettinger de Cuba; Timothy C Heeren; Ruth Rose-Jacobs; Megan Sandel; Patrick H Casey; Sharon Coleman; Ingrid Weiss; Deborah A Frank Journal: Adv Nutr Date: 2013-01-01 Impact factor: 8.701
Authors: Jennifer Vehawn; Rickelle Richards; Joshua H West; P Cougar Hall; Benjamin T Crookston; Brad L Neiger Journal: J Immigr Minor Health Date: 2014-08
Authors: Ashwini Lakshmanan; Ashley Y Song; Nicole Flores-Fenlon; Urvashi Parti; Douglas L Vanderbilt; Philippe S Friedlich; Roberta Williams; Michele Kipke Journal: Clin Pediatr (Phila) Date: 2019-10-31 Impact factor: 1.168