Jing Sun1, Molly Knowles2, Falguni Patel2, Deborah A Frank3, Timothy C Heeren4, Mariana Chilton5. 1. Department of Epidemiology, Drexel University School of Public Health, Philadelphia, Pennsylvania. 2. Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania. 3. Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts. 4. Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts. 5. Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, Pennsylvania. Electronic address: mmc33@drexel.edu.
Abstract
INTRODUCTION: Exposure to childhood adversity, including abuse, neglect, and household dysfunction, is associated with negative long-term health and economic outcomes. Little is known about how adversity exposure in parents' early lives may be related to later food insecurity for parents and their children. This study investigated the association between female caregivers' adverse childhood experiences (ACEs) and household and child food insecurity, taking into account depressive symptoms. METHODS: This study used cross-sectional data from 1,255 female caregivers of children aged <4 years surveyed in an urban clinical setting from March 2012 through June 2014. Measures included sociodemographic characteristics; caregivers' ACEs, including abuse, neglect, and household dysfunction; depressive symptoms; and household and child food insecurity. Multinomial and logistic regression analyses assessed the relationship among ACEs, depressive symptoms, and household and child food security status. RESULTS: Caregiver depressive symptoms modified associations between ACEs and food insecurity level. After adjusting for covariates, caregivers reporting both depressive symptoms and four or more ACEs were 12.3 times as likely to report low food security (95% CI=6.2, 24.7); 28.8 times as likely to report very low food security (95% CI=12.8, 64.8); and 17.6 times as likely to report child food insecurity (95% CI=7.3, 42.6) compared with those reporting no depressive symptoms and no ACEs. CONCLUSIONS: Depressive symptoms and ACEs were independently associated with household and child food insecurity, and depressive symptoms modified the association between ACEs and household and child food insecurity. Comprehensive policy interventions incorporating nutrition assistance and behavioral health may address intergenerational transmission of disadvantage.
INTRODUCTION: Exposure to childhood adversity, including abuse, neglect, and household dysfunction, is associated with negative long-term health and economic outcomes. Little is known about how adversity exposure in parents' early lives may be related to later food insecurity for parents and their children. This study investigated the association between female caregivers' adverse childhood experiences (ACEs) and household and child food insecurity, taking into account depressive symptoms. METHODS: This study used cross-sectional data from 1,255 female caregivers of children aged <4 years surveyed in an urban clinical setting from March 2012 through June 2014. Measures included sociodemographic characteristics; caregivers' ACEs, including abuse, neglect, and household dysfunction; depressive symptoms; and household and child food insecurity. Multinomial and logistic regression analyses assessed the relationship among ACEs, depressive symptoms, and household and child food security status. RESULTS: Caregiver depressive symptoms modified associations between ACEs and food insecurity level. After adjusting for covariates, caregivers reporting both depressive symptoms and four or more ACEs were 12.3 times as likely to report low food security (95% CI=6.2, 24.7); 28.8 times as likely to report very low food security (95% CI=12.8, 64.8); and 17.6 times as likely to report child food insecurity (95% CI=7.3, 42.6) compared with those reporting no depressive symptoms and no ACEs. CONCLUSIONS:Depressive symptoms and ACEs were independently associated with household and child food insecurity, and depressive symptoms modified the association between ACEs and household and child food insecurity. Comprehensive policy interventions incorporating nutrition assistance and behavioral health may address intergenerational transmission of disadvantage.
Authors: Henry J Whittle; Lila A Sheira; William R Wolfe; Edward A Frongillo; Kartika Palar; Daniel Merenstein; Tracey E Wilson; Adebola Adedimeji; Kathleen M Weber; Adaora A Adimora; Ighovwerha Ofotokun; Lisa Metsch; Janet M Turan; Eryka L Wentz; Phyllis C Tien; Sheri D Weiser Journal: J Nutr Date: 2019-08-01 Impact factor: 4.687
Authors: Kristin E Schneider; Catherine Tomko; Danielle Friedman Nestadt; Bradley E Silberzahn; Rebecca Hamilton White; Susan G Sherman Journal: Int J Drug Policy Date: 2020-07-22