Cristina R Fernández1, Maiko Yomogida2, Yumiko Aratani3, Diana Hernández2. 1. Department of Pediatrics, Columbia University Medical Center (CR Fernández). Electronic address: crf2101@cumc.columbia.edu. 2. Departments of Sociomedical Sciences (M Yomogida and D Hernández). 3. Departments of Health Policy and Management (Y Aratani), Columbia University Mailman School of Public Health, New York, NY.
Abstract
OBJECTIVE: To examine dual food and energy hardship and internalizing and externalizing behavior problems in 9-year-old children. METHODS: We conducted a cross-sectional analysis of the Fragile Families and Child Wellbeing Study, a prospective national urban birth cohort, when the children were 9 years old. Maternal-reported "food hardship" (ever hungry and/or ever received free food) and "energy hardship" (ever unable to pay utility bill and/or utility shutoff) within the past year, and child behavior using the Child Behavior Checklist for Ages 6-18 were assessed. Multiple logistic regression analyses estimated associations between individual and dual food and energy hardship and child behavior problems, adjusting for a priori covariates (ie, child sex, health insurance, maternal sociodemographic characteristics, poverty, reported health, attention deficit hyperactivity disorder, depressive symptoms, smoking, and substance and alcohol abuse). RESULTS: Approximately 10% of households reported dual food and energy hardship. Children experiencing dual food and energy hardship had 3 times greater odds of withdrawn/depressed behaviors (adjusted odds ratio [AOR], 2.8; 95% confidence interval [CI], 1.4-5.5), threefold greater odds of somatic complaints (AOR, 3.2; 95% CI, 1.5-6.9), and 4 times greater odds of rule-breaking behavior (AOR, 3.7; 95% CI, 1.5-9.2) in the borderline/clinical range than children with no hardship, and had fourfold greater odds of borderline/clinical range somatic complaints (AOR, 4.2; 95% CI, 1.7-10.3) than children with only energy hardship. CONCLUSIONS: Children experiencing dual food and energy hardship have greater odds of coexisting internalizing and externalizing behaviors after controlling for possible confounders. Providers can consider screening and resource referrals for these addressable hardships alongside behavior assessments in the clinical setting.
OBJECTIVE: To examine dual food and energy hardship and internalizing and externalizing behavior problems in 9-year-old children. METHODS: We conducted a cross-sectional analysis of the Fragile Families and Child Wellbeing Study, a prospective national urban birth cohort, when the children were 9 years old. Maternal-reported "food hardship" (ever hungry and/or ever received free food) and "energy hardship" (ever unable to pay utility bill and/or utility shutoff) within the past year, and child behavior using the Child Behavior Checklist for Ages 6-18 were assessed. Multiple logistic regression analyses estimated associations between individual and dual food and energy hardship and child behavior problems, adjusting for a priori covariates (ie, child sex, health insurance, maternal sociodemographic characteristics, poverty, reported health, attention deficit hyperactivity disorder, depressive symptoms, smoking, and substance and alcohol abuse). RESULTS: Approximately 10% of households reported dual food and energy hardship. Children experiencing dual food and energy hardship had 3 times greater odds of withdrawn/depressed behaviors (adjusted odds ratio [AOR], 2.8; 95% confidence interval [CI], 1.4-5.5), threefold greater odds of somatic complaints (AOR, 3.2; 95% CI, 1.5-6.9), and 4 times greater odds of rule-breaking behavior (AOR, 3.7; 95% CI, 1.5-9.2) in the borderline/clinical range than children with no hardship, and had fourfold greater odds of borderline/clinical range somatic complaints (AOR, 4.2; 95% CI, 1.7-10.3) than children with only energy hardship. CONCLUSIONS: Children experiencing dual food and energy hardship have greater odds of coexisting internalizing and externalizing behaviors after controlling for possible confounders. Providers can consider screening and resource referrals for these addressable hardships alongside behavior assessments in the clinical setting.
Authors: Deborah A Frank; Patrick H Casey; Maureen M Black; Ruth Rose-Jacobs; Mariana Chilton; Diana Cutts; Elizabeth March; Timothy Heeren; Sharon Coleman; Stephanie Ettinger de Cuba; John T Cook Journal: Pediatrics Date: 2010-04-12 Impact factor: 7.124
Authors: Maryah Stella Fram; Edward A Frongillo; Sonya J Jones; Roger C Williams; Michael P Burke; Kendra P DeLoach; Christine E Blake Journal: J Nutr Date: 2011-04-27 Impact factor: 4.798
Authors: Deborah A Frank; Nicole B Neault; Anne Skalicky; John T Cook; Jacqueline D Wilson; Suzette Levenson; Alan F Meyers; Timothy Heeren; Diana B Cutts; Patrick H Casey; Maureen M Black; Carol Berkowitz Journal: Pediatrics Date: 2006-11 Impact factor: 7.124
Authors: John T Cook; Deborah A Frank; Patrick H Casey; Ruth Rose-Jacobs; Maureen M Black; Mariana Chilton; Stephanie Ettinger de Cuba; Danielle Appugliese; Sharon Coleman; Timothy Heeren; Carol Berkowitz; Diana B Cutts Journal: Pediatrics Date: 2008-10 Impact factor: 7.124
Authors: Ruth Rose-Jacobs; Maureen M Black; Patrick H Casey; John T Cook; Diana B Cutts; Mariana Chilton; Timothy Heeren; Suzette M Levenson; Alan F Meyers; Deborah A Frank Journal: Pediatrics Date: 2008-01 Impact factor: 7.124
Authors: Laura Oliveras; Carme Borrell; Irene González-Pijuan; Mercè Gotsens; María José López; Laia Palència; Lucía Artazcoz; Marc Marí-Dell'Olmo Journal: Int J Environ Res Public Health Date: 2021-06-02 Impact factor: 3.390