Poverty, Food Insecurity, and the Behavior for Childhood Internalizing and Externalizing Disorders
Accepted 16 February 2010. published online 05 April 2010.
Refers to article:
Access to Food: Getting to Some of the Root Mediators of Psychiatric Illness
Tamara Dubowitz
Journal of the American Academy of Child & Adolescent Psychiatry
May 2010 (Vol. 49, Issue 5, Pages 437-438) Full Text |
Full-Text PDF (102 KB)
Objective
This study investigated the associations of poverty and food insecurity over a 2-year period with internalizing and externalizing problems in a large, community-based sample.
Method
A total of 2,810 children were interviewed between ages 4 and 14 years at baseline, and between ages 5 and 16 years at follow-up. Primary caregivers reported on household income, food insecurity, and were administered the Child Behavior Checklist, from which we derived indicators of clinically significant internalizing and externalizing problems. Prevalence ratios for the associations of poverty and food insecurity with behavior problems were estimated.
Results
At baseline, internalizing and externalizing problems were significantly more prevalent among children who lived in poor households than in nonpoor households, and among children who lived in food insecure households than in food-secure households. In adjusted analyses, children from homes that were persistently food insecure were 1.47 (95% CI = 1.12 to 1.94) times more likely to have internalizing problems and 2.01 (95% CI = 1.21 to 3.35) times more likely to have externalizing problems compared with children from households that were never food insecure. Children from homes that moved from food secure to insecure were 1.78 (95% CI = 1.07 to 2.94) times more likely to have externalizing problems at follow-up.
Conclusions
Persistent food insecurity is associated with internalizing and externalizing problems, even after adjusting for sustained poverty and other potential confounders. These results implicate food insecurity as a novel risk factor for child mental well-being; if causal, this represents an important factor in the etiology of child psychopathology, and potentially a new avenue for prevention.
Correspondence to Natalie Slopen: Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115
This work was supported by a doctoral research award from the Canadian Institutes of Health Research (Award 200610MDR-168591-163832).
Disclosure: Ms. Slopen and Drs. Fitzmaurice, Williams, and Gilman report no biomedical financial interests or potential conflicts of interest.
This article is discussed in an editorial by Dr. Tamara Dubowitz on page 437.
ABSTRACT