May 2016

The Issue

Female caregivers exposed to Adverse Childhood Experiences (ACEs), including abuse, neglect, and household instability in childhood, are more likely to report food insecurity as adults and among their own children, particularly if they also experience depressive symptoms.

Adverse Childhood Experiences (ACEs) are experiences before the age of 18 that include:

• Emotional, physical, and sexual abuse
• Emotional and physical neglect
• Household instability, including loss or abandonment of a parent, domestic violence, mental illness, substance abuse, and incarceration of a household member

ACEs are associated with poor physical and mental health. Food insecurity is defined as lack of access to enough food for an active and healthy life because of economic hardship. It can be measured at the household and child levels. Food insecurity is categorized into low food security and very low food security, a more severe form.

Our Research

Through the Children’s HealthWatch Philadelphia study, we interviewed 1,255 Philadelphia mothers of children under 4 years about their ACEs, depressive symptoms, and current food security status for their households and children. ACEs were given a score from 0-10, with each experience counting for 1 point. Food insecurity was categorized into food secure, low food secure, and very low food secure at both the household and child level. We measured the relationship between mothers’ ACE score and household and child food security status. We also measured if mothers’ depressive symptoms affected that relationship. 

What We Found

Compared to caregivers with no ACEs or depressive symptoms, caregivers who reported depressive symptoms and 4+ ACEs were about 12 times as likely to report low household food security and about 29 times as likely to report very low household food security. Compared to caregivers with no ACEs or depressive symptoms, caregivers who reported depressive symptoms and 4+ ACEs were about 18 times as likely to report food insecurity among their own children (not shown).

Conclusions

The more Adverse Childhood Experiences a caregiver reported, the more likely she was to report more severe forms of food insecurity. Among caregivers who reported ACEs, those who reported depressive symptoms had an increased risk of both household and child food insecurity. 

Recommendations

1. Two-Generation Approach
   Invest in coordinated programs that support families in order to address the mental health and economic stability of caregivers simultaneously with the health and development of children.
2. Scale Up Systems Approaches
   Develop comprehensive policy interventions that combine nutrition assistance and behavioral health support to address intergenerational transmission of disadvantage.

For more information about this study, please see the following article: Childhood adversity and adult reports of food insecurity among households with children (2016). American Journal of Preventive Medicine.