Sequences and Combinations of Food Insecurity and Depression Associated with Parenting and Child Development

Purpose: Food insecurity and maternal depression negatively impact children’s development, separately and in combination.  Food insecurity influences children through its impact on maternal mental health, and maternal mental health influences children in part through its impact on food insecurity.  Better understanding of which sequences and combinations of food insecurity and maternal depression occur, for whom, and with what consequences can help inform policy and practice.  

Methods: Using Early Childhood Longitudinal Study-Birth cohort data, we categorized families based on two factors, food insecurity status and maternal depression, at two points (waves 1 and 3).  We compared characteristics of families and children across the combinations of food insecurity and maternal depression, then examined the relationships between those combinations and a set of parenting and child outcomes, adjusting for household socio-economic and demographic factors.

Results: The presence or onset of depression alone was associated with fewer household disadvantages, greater socio-economic privilege, and better outcomes for children than was the presence or onset of food insecurity alone.  Families experiencing onset of depression following food insecurity (FI -> FI&D) versus onset of food insecurity following depression (D ->FI&D) were distinct in several ways.  Families experiencing FI->FI&D on average had lower maternal education, were disproportionately Hispanic, and showed a greater increase in single-parent status between waves.  Families experiencing D->FI&D were disproportionately white, and had decreasing household income.  By wave 3, SNAP participation (among families < 130% FPL) in the D->FI&D group was as high (71.48%) as the FI->FI&D group (70.41%), and higher than the groups with wave 3 onset of food insecurity alone (51.45%), or joint onset of depression and food insecurity (61.02%).

With families experiencing no food insecurity or maternal depression as the reference group for regression analyses, maternal stress was greater for those depressed, experiencing D->FI&D, and with joint food insecurity and depression at both waves. Maternal provision of emotional support, child’s quality of play, and child health were lower among those experiencing FI ->FI&D, while provision of cognitive stimulation was lower among those experiencing D ->FI&D. Child’s body mass index was higher and math scores lower with joint onset of food insecurity and maternal depression at wave 3.

Conclusion/Implications: Food insecurity and maternal depression, separately and jointly, were associated with problematic parenting and child outcomes.  Food insecurity leading to depression was associated with more structural barriers to wellbeing (lower maternal education, becoming a single-parent family, traditionally marginalized minority status), while depression leading to food insecurity was associated primarily with decreasing income.  Although both sets of experiences exacerbated maternal stress, children experienced a wider range of parenting and developmental deficits associated with the FI->FI&D pattern.  The joint onset of food insecurity and depression is particularly concerning given the significant increase in body mass index and its potential health consequences.  Overall, this research suggests that food insecurity, both alone and in relation to maternal depression, is a marker of structural and family-process risks that require additional policy attention, tailored to the varied family situations and characteristics through which food insecurity and maternal depression unfold.