Household Food Insecurity Predictive of Health Status in Early Adolescence? A Structural Analysis Using the 2002 NSAF Data Set

We used data from the 2002 National Survey of American Families to examine a structural model of the relations among food insecurity, poor nutritional status, parental mental health problems, quality of parenting, adolescents’ emotional distress, and poor health status for a national sample of 5366 12-to-14 year-olds. The results revealed that: first, food insecurity was associated with elevated levels of parental mental health problems, diminished quality of parenting, elevated levels of adolescents’ emotional problems, and higher incidence of poor nutritional and health statuses. Second, parental mental health problems were associated with diminished quality of parenting and higher incidence of poor health status; and quality of parenting had a negative effect on emotional distress, but not on health status. Finally, poor nutritional status was associated with elevated levels of emotional distress and higher incidence of poor health status; and emotional distress was predictive of poor health status. The findings of this study highlight the mediating role of nutritional status, parenting factors and adolescents’ emotional well-being in the link between food insecurity and health; and point to the complex interaction between food insecurity and health status

Children's Health Status: Examining the Associations among Income Poverty, Material Hardship, and Parental Factors

BACKGROUND: We examined a model of multiple mediating pathways of income poverty, material hardship, parenting factors, and child health status to understand how material hardship and parental factors mediate the effects of poverty on child health. We hypothesized that: (a) poverty will be directly associated with material hardship, parental depression, and health status, and indirectly with parenting behaviors through its effects on parental depression and material hardship; (b) material hardship will be associated with parental depression, parenting behaviors, and health status; and (c) parental depression will be correlated with parenting behaviors, and that both parental depression and parenting behaviors will predict child health. METHODS AND RESULTS: We used data from the 2002 National Survey of American Families for a sample of 9,645 6-to-11 year-olds to examine a 4-step structural equation model. The baseline model included covariates and income poverty. In the hardship model, food insufficiency and medical need were added to the baseline model. The parental model included parental depression and parenting behavior and baseline model. In the full model, all the constructs were included. First, income poverty had a direct effect on health status, and an indirect effect through its association with material hardship, parental depressive affect, and parenting behaviors. Medical need and food insufficiency had negative effects on child health, and indirect effects on health through their association with parental depression and parenting behaviors. Finally, parental depression and parenting behaviors were associated with child health, and part of the effect of parental depression on health was explained by its association with parenting behaviors. CONCLUSIONS: Poverty has an independent effect on health, however, its effects are partially explained by material hardship, parental depression and parental behaviors. To improve children's health would require a multi-pronged approach involving income transfers, health insurance coverage, food and nutrition assistance, and parenting interventions

Model linking Income, Material Hardship, and Parenting to Child Health Status.

<p>Model linking Income, Material Hardship, and Parenting to Child Health Status.</p

Model of Income Poverty, Material Hardship, Parenting, and Health Status.

<p>Unstandardized coefficients (SE), and standardized coefficients (bold face) are reported. Note. Covariate coefficients are reported for poverty and [health status].</p

Summary of 4-Step Structural Equation Model Building.

<p>* <i>p</i><.01; ** = <i>p</i><.001; ^a = Standardized β; SE = (standard error).</p

Unweighted Descriptive Statistics of Study Sample.

<p>Unweighted Descriptive Statistics of Study Sample.</p