The Role of SNAP and WIC in the Bidirectional Relationship between Food Insecurity and Maternal Depressive Symptoms

Food insecurity is a major stressor for families and is known to undermine mothers’ mental health (Davison et al., 2015). This association has been established by many cross-sectional and longitudinal studies (Jones, 2017; Kolovos et al., 2020). On the contrary, some studies have found depressive symptoms as a risk factor predicting food insecurity (Garg et al., 2015). Hence the understanding of the reciprocal causal relationship between these two variables remains unclear. Thus, the current study examined the bidirectional associations between depressive symptoms and food insecurity using the cross-lagged models and then tested the main and moderating effects of SNAP and WIC.

Data were from the Future of Families and Child Wellbeing Study (FFCWS), a longitudinal birth cohort study of children born in the U.S. between 1998 and 2000 across 20 large U.S. cities. The sample was limited to 1,461 mothers who were below 200% of the federal poverty line and participated in year 3 and year 5 of data collection. Mothers reported depressive symptoms using the CIDI-SF (Kessler et al., 1998). Food insecurity was measured using the 18-items from the United States Department of Agriculture (USDA) food security survey. Receipt of SNAP and WIC was assessed asking the mothers whether they had received SNAP and WIC last year. Various individual and family-level covariates were included in the model.

The hypothesized models were tested using cross-lagged models in Mplus. The results demonstrated that within time correlations between food insecurity and maternal depressive symptoms were significant across the two time points, such as higher food insecurity was concurrently related to higher maternal depressive symptoms. The autoregressive paths between food insecurity (β = .44, p = .00) and maternal depressive symptoms (β = .30, p = .00) were significant and remained highly stable across the two time points. The cross-lagged paths show that food insecurity at year 3 predicted maternal depressive symptoms at year 5 (β = .06, p = .02) and depressive symptoms at year 3 predicted food insecurity at year 5 (β = .06, p = .01). The main effect of WIC on food insecurity and depressive symptoms was negative and not significant. However, there was a significant moderating effect of WIC receipt on the association between food insecurity at year 3 and at year 5 (b = -.17, p = .04) such that when mothers with high food insecurity at year 3 received WIC, they were less food insecure at year 5. On the contrary, WIC receipt among less food insecure households predicted more food insecurity at year 5. There were positive and non-significant main and moderating effects of SNAP on depressive symptoms and food insecurity at year 5.

The bidirectional associations between food insecurity and maternal depressive symptoms demonstrate the need to incorporate mental health services with the existing food assistance programs. Moreover, the prevalence of mental health problems associated with welfare stigma among the beneficiaries is well documented in the literature (Pak, 2020) and indicates the need to destigmatize the application process and program structure.