Journal of Health Care for the Poor and Underserved (May 2021)
Emily Brown Weida, Victoria Egan, Mariana Chilton
Cross-sector collaboration and systems alignment to promote a culture of health can address social determinants of health (SDH), improve family well-being, and create a more equitable society. This paper documents our attempt to align Temporary Assistance for Needy Families (TANF) and Medicaid to promote health through a trauma-informed program, The Building Wealth and Health Network (The Network). The Network successfully integrated into traditional TANF and addresses SDH through peer-group programming where caregivers heal from adversity and build financial skills. We identify three challenges to alignment of TANF and Medicaid: 1) TANF’s culture of compliance, 2) societal and systems-level forces including racism and discrimination, 3) misaligned partnerships (values, priorities, structure, and capability). For each challenge, we propose solutions including incentives for innovation and partnership, and promotion of racial equity initiatives, including reparations. By highlighting challenges and solutions we seek to strengthen current approaches to achieve health equity through systems alignment.
2020
Social Science & Medicine (August 2020)
Jerome Dugana, Layla Booshehri, Pam Phojanakong, Falguni Patel, Emily Brown, Sandra Bloom, Mariana Chilton
Integrating trauma-informed peer support curriculum into the Temporary Assistance for Needy Families (TANF) program can help address caregiver trauma symptoms caused by exposures to violence and adversity that negatively impact one’s ability to maintain employment and improve earnings; yet, it is unclear if trauma-informed peer support interventions designed for TANF impact co-occurring disorders, such as depression and substance abuse, that inhibit resiliency in the labor market. The aim of this study is to examine whether integrating trauma-informed peer support curriculum into the TANF program is associated with reductions in co-occurring depression and substance abuse, and improvements in self-efficacy and economic security. These findings suggest that trauma-informed peer support programming improves economic security and self-efficacy and reduces the co-occurrence of depressive symptoms and alcohol abuse.
PLOS One (May 2020)
Emily Brown Weida, Pam Phojanakong, Falguni Patel, Mariana Chilton
Financial health, understood as one’s ability to manage expenses, prepare for and recover from financial shocks, have minimal debt, and ability to build wealth, underlies all facets of daily living such as securing food and paying for housing, yet there is inconsistency in measurement and definition of this critical concept. Most social determinants research and interventions focus on siloed solutions (housing, food, utilities) rather than on a root solution such as financial health. In light of the paucity of public health research on financial health, particularly among low-income populations, this study seeks to: 1) introduce the construct of financial health into the domain of public health as a useful root term that underlies other individual measures of economic hardship and 2) demonstrate through outcomes on financial, physical and mental health among low-income caregivers of young children that the construct of financial health belongs in the canon of social determinants of health.
Journal of Nutrition Education and Behavior (May 2020)
Pam Phojanakong, Seth Welles, Jerome Dugan, Layla Booshehri,
Emily Brown Weida, Mariana Chilton
Food insecurity, or the lack of access to enough food for an active
and healthy life because of limited economic resources, is a major
public health challenge associated with negative health outcomes
such as higher rates of hospitalization and developmental risk among
infants, children, and adolescents, as well as higher rates of
depression and chronic disease among adults. This study sought to
test the effectiveness of a trauma-informed intervention to reduce
household food insecurity, called the Building Wealth and Health
Network (the Network). The Network was designed to improve health
and economic security among parents of children under the age of 6
years, participating in public assistance programs.
American Journal of Public Health (March 2020)
Mariana Chilton, Sonya Jones
Public health is faced with a choice at this critical moment. Do we
continue with business as usual, addressing the diseases of
modernity, such as heart disease, without questioning the values
underlying modernity? Or do we do what we in public health are best
suited to do: transform the paradigm of health to be more inclusive
and better encompass our current challenges?
2019
American Journal of Public Health (December 2019)
Tianna Gaines-Turner, Joanna Cruz Simmons, Mariana Chilton
SNAP is ensnared in much larger problems in US society related to
the stigmatization of people who are poor and a lack of appreciation
for the value and skills of their work. We encourage the public
health community to think beyond SNAP, focus more assertively on
wages and work supports, and replace our means-tested safety net
with a new system of universal income that promotes equity,
inclusion, and health for all. Although we offer recommendations to
improve SNAP, the goal of most SNAP recipients has always been to
move beyond the need for this program. The public health community
can take the lead in finding more egalitarian, dignified, and
effective ways to address poverty and food insecurity.
International Journal of Environmental Research and Public
Health
(November 2019)
Pam Phojanokang, Emily Brown Weida, Gabriella Grimaldi,
Fêlice Lê-Scherban, Mariana Chilton
This study examines the associations of mothers' experiences of
discrimination with household food insecurity, physical health, and
depressive symptoms, while taking into account the influence of
mothers' Adverse Childhood Experiences (ACEs) and public assistance
participation. Mothers of young children under age 4 who
self-identified as Latinx, Non-Latinx Black/African American and
Non-Latinx white answered questions for a cross-sectional survey in
an emergency room in a large children's hospital in Philadelphia
between 2016 and 2018. Compared to those without experiences of
discrimination, mothers with experiences of discrimination from
police/courts and in workplaces had higher odds of household food
insecurity.
American Journal of Preventive Medicine (November 2019)
Dylan Jackson, Mariana Chilton, Kecia Johnson, Michael Vaughn
Research has linked adverse childhood experiences to a host of
negative health outcomes. The present study examines the link
between individual and cumulative adverse childhood experience
exposure and household food insecurity in a recent, nationally
representative sample of children, and whether parent self-rated
well-being attenuates these associations.
American Journal of Preventive Medicine (October 2019)
Stephanie Ettinger de Cuba, Allison Bovell-Ammon, John Cook, Sharon
Coleman, Maureen Black, Mariana Chilton, Patrick Casey, Diana Cutts,
Timothy Herren, Megan Sandel, Richard Sheward, Deborah Frank
The Supplemental Nutrition Assistance Program is the largest
nutrition assistance program in the U.S. This study's objective was
to examine the associations between SNAP participation and young
children's health and development, caregiver health, and family
economic hardships.
Pediatrics (September 2019)
Chloe Drennen, Sharon Coleman, Stephanie Ettinger de Cuba, Deborah
Frank, Mariana Chilton, John Cook, Diana Cutts, Timothy Heeren,
Patrick Casey, Maureen Black
Food insecurity and pediatric obesity affect young children. We
examine how food insecurity relates to obesity, underweight,
stunting, health, and development among children less than 4 years
of age. Among these children, food insecurity is associated with
fair or poor health and developmental risk, not with anthropometry.
Findings support American Academy of Pediatrics recommendations for
food insecurity screening and referrals to help families cope with
economic hardships and associated stressors.
Academic Pediatrics (September 2019)
Margot Tang, Stephanie Ettinger de Cuba, Sharon Coleman, Timothy
Heeran, Megan Sandel, Mariana Chilton, Deborah Frank, Susanna Huh
Among US-born children of Latina US and Latina foreign-born mothers,
to determine whether 1) household and child characteristics differ;
2) child health outcomes differ; 3) these differences diminish for
children of foreign-born mothers with longer duration of residence
in the US; and 4) these differences can be explained by food
insecurity or by Supplemental Nutrition Assistance Program
participation.
Psychiatric Services (July 2019)
Jonathan Purtie, Fêlice Lê-Scherban, Xi Wang, Emily
Brown, Mariana Chilton
Adverse childhood experiences (ACEs) increase risk of adult
behavioral health conditions. State legislators are an important
audience to target with evidence about ACEs because they make policy
decisions that can prevent ACE exposure and enhance resilience. This
study sought to describe state legislators' opinions about ACEs as
risk factors for adult behavioral health conditions and identify how
opinions vary between legislators with different characteristics.
Pediatrics (July 2019)
Ruth Rose-Jacobs, Stephanie Ettinger de Cuba, Allison Bovell-Ammon,
Maureen M. Black, Sharon M. Coleman, Diana Cutts, Mariana Chilton,
Timothy Heeren, Patrick Casey, Eduardo Ochoa, Deborah Frank, Megan
Sandel
Children with special health care needs (SHCNs) have significant
medical and educational expenses affecting household finances.
Housing instability can be detrimental to family well-being. Our
objective was to evaluate housing instability in households of
children with and without SHCNs.
Health Affairs (May 2019)
Stephanie Ettinger de Cuba, Mariana Chilton, Allison Bovell-Ammon,
Moly Knowles, Sharon M. Coleman, Maureen Black, John Cook, Diana
Becker Cutts, Patrick Casey, Timothy Heeren, Deborah Frank
The Supplemental Nutrition Assistance Program (SNAP) helps working
families meet their nutritional needs. Families whose earned income
increases in a given month may have their SNAP benefits abruptly
reduced or cut off in the following month. Using sentinel sample
data from 2007-15 for families with children younger than age four,
we investigated how SNAP benefit reductions or cutoffs resulting
from increased income were related to economic hardships (food and
energy insecurity, unstable housing, forgone health and/or dental
care, and health cost sacrifices) and to caregiver and child health.
International Journal of Environmental Research and Public Health
February 2019)
Danielle Gallegos, Mariana Chilton
Drawing on examples from Australia and the United States, we outline
the benefits of sharing expertise to identify new approaches to food
and nutrition security. While there are many challenges to sharing
expertise such as discrimination, academic expectations, siloed
thinking, and cultural differences, we identify principles and
values that can help food insecurity researchers to improve
solutions.
2018
Pediatrics (September 2018)
Megan Sandel, Richard Sheward, Stephanie Ettinger de Cuba, Sharon
Coleman, Timothy Heeren, Maureen Black, Patrick Casey, Mariana
Chilton, John Cook, Diana Becker Cutts, Ruth Rose-Jacobs, Deborah
Frank
After controlling for birth outcomes, the stress of prenatal and
postnatal homelessness was found to be associated with an increased
risk of adverse pediatric health outcomes relative to those who were
never homeless. Interventions to stabilize young families as quickly
as possible in adequate and affordable housing may result in
improved pediatric health outcomes.
Journal of Health Care for the Poor and Undeserved (February
2018)
Molly Knowles, Saba Khan, Deepak Palakshappa, Rachel Cahill, Evelyne
Kruger, Bridget Poserina, Brittany Koch, Mariana Chilton
This study evaluated a food insecurity screening and referral
program collaboration between Children's Hospital of Philadelphia
(CHOP) and Benefits Data Trust (BDT). Of 7,284 families with
children under five screened for food insecurity, over one thousand
reported food insecurity and 630 were referred to a benefits access
organization for connection to public benefits and community
resources. This study used screening and referral data from CHOP and
BDT along with key informant interviews and focus groups with 19
caregivers and 11 clinic staff to evaluate the initiative's
effectiveness. Results demonstrate importance of integrated
screening and referral consent processes, strong communication, and
convenient outreach for families.
Journal of Child and Family Studies (January 2018)
Layla G. Booshehri, Jerome Dugan, Falguni Patel, Sandra
Bloom, Mariana Chilton
Temporary Assistance for Needy Families (TANF) has limited success
in building self-sufficiency, and rarely addresses exposure to
trauma as a barrier to employment. The Building Wealth and Health
Network's randomized controlled trial tested the effectiveness of
financial empowerment combined with trauma-informed peer support
against standard TANF programming. Despite high exposure to trauma
and adversity, caregivers in the full intervention (financial
empowerment and trauma-informed peer support) reported improved
self-efficacy and depressive symptoms, and reduced economic hardship
compared to the control and partial intervention groups. We conclude
that financial empowerment education with trauma-informed peer
support is more effective than standard TANF programming at
improving behavioral health, reducing hardship, and increasing
income. Policymakers may consider adapting TANF to include
trauma-informed programming.
Pediatrics (January 2018)
Megan Sandel, Richard Sheward, Stephanie Ettinger de Cuba, Sharon
Coleman, Deborah Frank, Mariana Chilton, Maureen Black, Timothy
Heeren, Justin Pasquariello, Patrick Casey, Eduardo Ochoa, Diana
Cutts
Caregivers of children 0 to 48 months of age were interviewed in
five urban medical centers from May 2009 to December 2015.
Caregivers reported on the following: caregiver health, maternal
depressive symptoms, child's health, lifetime hospitalizations,
developmental risk, and three housing circumstances, which were
categorized as being behind on rent in the past 12 months, multiple
moves, and child's lifetime history of homelessness. Of 22,324
families, 34% had at least one of the following adverse housing
circumstances: 27% had been behind on rent, 8% had made multiple
moves, and 12% had a history of being homeless. We concluded that
three forms of housing instability were associated with adverse
caregiver and child health among low-income renter households. The
American Academy of Pediatrics recommends social screening within
health care; providers could consider assessing for behind on rent,
multiple moves, and homelessness in high-risk practices.
2016
BioMed Central Public Health (July 2016)
Jing Sun, Falguni Patel, Rachel Kirzner, Nijah Newton-Famous,
Constance Owens, Seth L. Welles, Mariana Chilton
Families with children under age six participating in the Temporary
Assistance for Needy Families Program (TANF) must participate in
work-related activities for 20 hours per week. However, due to
financial hardship, poor health, and exposure to violence and
adversity, families may experience great difficulty in reaching self
sufficiency. The purpose of this report is to describe study design
and baseline findings of a trauma-informed financial empowerment and
peer support intervention meant to mitigate these hardships.
American Journal of Preventive Medicine (May 2016)
Jing Sun, Molly Knowles, Falguni Patel, Deborah Frank, Timothy
Heeren, Mariana Chilton
Exposure to childhood adversity, including abuse, neglect, and
household dysfunction, is associated with negative long-term health
and economic outcomes. This study used cross-sectional data from
1,255 female caregivers of children under 4 years surveyed in an
urban clinical setting to investigate the association between
caregivers' adverse childhood experiences (ACEs) and household and
child food insecurity, taking into account depressive symptoms.
Depressive symptoms and ACEs were independently associated with
household and child food insecurity, and depressive symptoms
modified the association between ACEs and household and child food
insecurity. Comprehensive policy interventions incorporating
nutrition assistance and behavioral health may address
intergenerational transmission of disadvantage.
Journal of Hunger & Environmental Nutrition (May 2016)
Mariana Chilton, Molly Knowles, Sandra Bloom
Household food insecurity is linked with exposure to violence and
adversity throughout the life course, suggesting its transfer across
generations. Using grounded theory, we analyzed semistructured
interviews with 31 mothers reporting household food insecurity where
participants described major life events and social relationships.
Through the lens of multigenerational interactions, 4 themes
emerged: (1) hunger and violence across the generations, (2)
disclosure to family and friends, (3) depression and problems with
emotional management, and (4) breaking out of intergenerational
patterns. After describing these themes and how they relate to
reports of food insecurity, we identify opportunities for social
services and policy intervention.
Journal of Developmental & Behavioral Pediatrics (February
2016)
Ruth Rose-Jacobs, Jennifer Goodhart Fiore, Stephanie Ettinger de
Cuba, Maureen Black, Diana Cutts, Sharon Coleman, Timothy Heeren,
Mariana Chilton, Patrick Casey, John Cook, Deborah Frank
The purpose of this research is to assess food insecurity in
low-income households with young children with and without special
health care needs (SHCN) and evaluate relationships between child
Supplemental Security Income (SSI) receipt and food insecurity. A
cross-sectional survey of caregivers was conducted at 5 medical
centers. Of 6,724 index children, 81.5% screened negative for SHCN,
14.8% positive for SHCN (no SSI), and 3.7% had SHCN and received
SSI. Among households with children with SHCN, those with children
receiving, versus not receiving SSI, were more likely to report
household but not child food insecurity. Low-income households with
young children having SHCN are at risk for food insecurity,
regardless of child SSI receipt and household participation in other
public assistance programs. Policy recommendations include
reevaluation of assistance programs' income and medical deduction
criteria for households with children with SHCN to decrease the food
insecurity risk faced by these children and their families.
2015
Human Organization (August 2015)
Molly
Knowles, Jenny Rabinowich, Tianna Gaines-Turner, Mariana Chilton
Food insecurity is an under-recognized public health crisis in the
United States affecting 19.5 percent of households with children and
35.4 percent of female-headed households with children. In 2013,
approximately 15.8 million children (21.4%) lived in households that
reported food insecurity, and 8.5 million children (23.7%) under age
six lived in food insecure households. Lack of public attention and
recent decisions by policymakers to cut nutrition assistance
programs call into question current efforts to raise awareness and
communicate about hunger and its public health impacts. As one
contribution, we describe the methods of Witnesses to Hunger, a
photovoice and participatory action research model of collaboration
with low-income caregivers of young children who participate in
nutrition assistance programs and offer solutions to public health
professionals, policymakers, and journalists.
Maternal and Child Health Journal (July 2015)
Molly Knowles, Jenny Rabinowich, Stephanie Ettinger de Cuba, Diana
Becker Cutts, Mariana Chilton
This study among 51 parents of young children under age four
investigated how parents that report marginal, low and very low food
security characterize how trade-offs associated with food insecurity
affect parents' mental health and child well-being. We carried out
51 semi-structured audio-recorded interviews after participants
responded to a survey regarding food security status and maternal
depressive symptoms. Among participants reporting both food
insecurity and depressive symptoms, we identified three primary
areas of concern: trade-offs, mental health, and child well-being.
Parents described how trade-offs associated with food insecurity
have a profound relationship with their mental health and home
environment that strongly affects young children. Partnerships
between healthcare providers, policymakers, and parents are
essential to successfully address and prevent the poor child health
outcomes of toxic stress associated with food insecurity and
poverty.
Housing Policy Debate (April 2015)
Kathryn
Bailey, John Cook, Stephanie Ettinger de Cuba, Patrick Casey,
Mariana Chilton, Sharon Coleman, Diana Becker Cutts, Timothy Heeren,
Ruth Rose-Jacobs, Maureen Black, Deborah Frank
Housing insecurity is a known threat to child health understanding
predictors of housing insecurity can help inform policies to protect
the health of young children in low-income households. This study
sheds light on the relationship between housing insecurity and
availability of housing that is affordable to low-income households.
We developed a county-level index of availability of subsidized
housing needed to meet the demand of low-income households. Our
results estimate that if subsidized units are made available to an
additional 5% of the eligible population, the odds of overcrowding
decrease by 26% and the odds of families making multiple moves
decrease by 31%. Both of these are known predictors of poor child
health outcomes. Thus, these results suggest that state and federal
investments in expanding the stock of subsidized housing could
reduce housing insecurity and thereby also improve the health and
well-being of young children, including their families' food
security status.
Journal of Applied Research on Children (February 2015)
Megan Sandel, Diana Cutts, Alan Meyers, Stephanie Ettinger de Cuba,
Sharon Coleman
The results of this study inform and support current efforts by
states to streamline online applications for social services and
remove statutory legal barriers to accessing these subsidies
simultaneously.
Preventing Chronic Disease (February 2015)
Amy
Hillier, Mariana Chilton, Quian-Wei Zhao, Dorota Szymkowiak, Ryan
Coffman, Giridhar Mallya
Tobacco advertising is widespread in urban areas with racial/ethnic
minority and low-income households that participate in nutrition
assistance programs. Tobacco sales and advertising are linked to
smoking behavior, which may complicate matters for low-income
families struggling with disparate health risks relating to
nutrition and chronic disease. We investigated the relationship
between the amount and type of tobacco advertisements on tobacco
outlets and the outlet type and location. Policy makers may be able
to mitigate the effects of this disparate exposure through tobacco
retail licensing, local sign control rules, and SNAP and WIC
authorization.
Public Health Nutrition (January 2015)
Mariana
Chilton, Molly Knowles, Jenny Rabinowich, Kimberly Arnold
Adverse childhood experiences, including abuse, neglect and
house-hold instability, affect lifelong health and economic
potential. The study investigates how adverse childhood experiences
are associated with food insecurity by exploring caregivers'
perceptions of the impact of their childhood adversity on
educational attainment, employment and mental health. Thirty-one
mothers of children under the age of four who reporter low or very
low household food security were interviewed. Participants described
the impact of childhood adverse experiences with emotional and
physical abuse/neglect, and household substance abuse, on their
emotional health, school performance and ability to maintain
employment. In turn, these experiences negatively affected their
ability to protect their children from food insecurity.
2013
Journal of Applied Research on Children (December 2013)
Allison Bovell, Stephanie Ettinger de Cuba, Patrick Casey, Sharon
Coleman, John Cook
Across the study period, households with SNAP were 17% less likely
to experience household food insecurity. Receipt of SNAP vs. no SNAP
was associated with decreased prevalence of household food
insecurity and child food insecurity during much of the economic
downturn; this impact waned as the buying power of the boost in
benefit amounts during the American Recovery Reinvestment Act period
eroded.
Pediatrics (May 2013)
Alan Meyers, Katherine
Joyce, Sharon Coleman, John Cook, Diana Cutts, Stephanie Ettinger de
Cuba, Timothy Heeren, Ruth Rose-Jacobs, Maureen Black, Patrick
Casey, Mariana Chilton, Megan Sandel, Deborah Frank
To ascertain measures of health status among 6- to 24-month-old
children classified as below normal weight-for-age by the Centers
for Disease Control and Prevention 2000 growth reference but as
normal weight-for-age by the World Health Organization 2006
standard.
2012
Public Health Nutrition (March 2012)
Mariana
Chilton, Jenny Rabinowich, Nicholas Woolf
Forty women described exposure to violence ranging from fear of
violence to personal experiences with rape. Exposure to violence
affected mental health, ability to continue school and obtain work
with living wages, and subsequently the ability to afford food.
Exposure to violence during childhood and being a perpetrator of
violence were both linked to very low food security status and
depressive symptoms. Ten of seventeen (59 %) participants reporting
very low food security described life-changing violence, compared
with three of fifteen (20 %) participants reporting low food
security and four of twelve (33 %) reporting food security. Examples
of violent experiences among the very low food secure group included
exposure to child abuse, neglect and rape that suggest exposure to
violence is an important factor in the experience of very low food
security. Descriptions of childhood trauma and life-changing
violence are linked with severe food security. Policy makers and
clinicians should incorporate violence prevention efforts when
addressing hunger.
Journal of Applied Research on Children (February 2012)
Mariana Chilton, Jenny Rabinowich
The causes and contexts of food insecurity among children in the
U.S. are poorly understood because the prevalence of food insecurity
at the child level is low compared to the prevalence of household
food insecurity. In addition, caregivers may be reluctant to admit
their children may not be getting enough food due to shame or fear
they might lose custody of their children. Based on our ongoing
qualitative research with mothers of young children, we suggest that
food security among children is related to adverse childhood
experiences of caregivers. This translates into poor mental and
physical health in adolescence and adulthood, which can lead to
inability to secure and maintain meaningful employment that pays a
living wage.
Journal of Applied Research on Children (February 2012)
Katherine Joyce, Amanda Breen, Stephanie Ettinger de Cuba, John
Cook, Kathleen Barrett, Grace Paik, Natasha Rishi, Bianca Pullen,
Ashley Schiffmiller, Deborah Frank
This paper explores Children's HealthWatch's research methods,
selected findings, and examples of diverse approaches to
dissemination of these findings in professional settings, national
and local reports and briefs, and legislative testimony.
2011
American Journal of Public Health (August 2011)
Diana Becker Cutts, Alan Meyers, Maureen Black, Patrick Casey,
Mariana Chilton, John Cook, Joni Geppert, Stephanie Ettinger de
Cuba, Timothy Heeren, Sharon Coleman, Ruth Rose-Jacobs, Deborah
Frank
Between 1998 and 2007, we interviewed 22069 low-income caregivers
with children younger than 3 years who were seen in 7 US urban
medical centers. We assessed food insecurity, child health status,
developmental risk, weight, and housing insecurity for each child's
household. Our indicators for housing insecurity were crowding and
multiple moves. After adjusting for covariates, crowding was
associated with household and child food insecurity compared with
the securely housed, as were multiple moves. Multiple moves were
associated with fair or poor child health, developmental risk, and
lower weight-for-age. Housing insecurity is associated with poor
health, lower weight, and developmental risk among young children.
Policies that decrease housing insecurity can promote the health of
young children and should be a priority.
2010
Pediatrics (July 2010)
Erin Hager, Anna Quigg,
Maureen Black, Sharon Coleman, Timothy Heeren, Ruth Rose-Jacobs,
John Cook, Stephanie Ettinger de Cuba, Patrick Casey, Mariana
Chilton, Diana Cutts, Alan Meyers, and Deborah Frank
The goal of this publication is to develop a brief screen to
identify families at risk for food insecurity and to evaluate the
sensitivity, specificity, and convergent validity of the screen.
Pediatrics (May 2010)
Deborah Frank, Patrick
Casey, Maureen Black, Ruth Rose-Jacobs, Mariana Chilton, Diana
Cutts, Elizabeth March, Timothy Heeren, Sharon Coleman, Stephanie
Ettinger de Cuba, John Book
The goals of this publication were to generate a cumulative hardship
index and to evaluate its association with the well-being of
children 4 to 36 months of age without private health insurance.
2009
Health and Human Rights (May 2009)
Mariana Chilton, Jenny
Rabinowich, Christina Council, Jennifer Breaux
When female-headed households and households with children have the
highest prevalence of food insecurity and hunger in the US, the
participation of low-income mothers in the development and
administration of policies is fundamental to the process of ending
hunger and improving child wellbeing.
American Journal of Public Health (March 2009)
Mariana Chilton, Maureen Black, Carol Berkowitz, Patrick Casey,
John Cook, Diana Cutts, Ruth Rose Jacobs, Timothy Heeren, Stephanie
Ettinger de Cuba, Sharon Coleman, Alan Meyers, Deborah A Frank
We investigated the risk of household food insecurity and reported
fair or poor health among very young children who were US citizens
and whose mothers were immigrants compared with those whose mothers
had been born in the United States.
Health and Human Rights (January 2009)
Mariana
Chilton and Donald Rose
Food insecurity is a serious public health problem associated with
poor cognitive and emotional development in children and with
depression and poor health in adults.
2008
Pediatrics (October 2008)
John Cook, Deborah
Frank, Patrick Casey, Ruth Rose-Jacobs, Maureen Black, Mariana
Chilton, Stephanie Ettinger de Cuba, Danielle Appugliese, Sharon
Coleman, Timothy Heeren, Carol Berkowitz, Diana Cutts
The objectives of this study were to develop a clinical indicator of
household energy security and assess associations with food
security, health, and developmental risk in children less than 36
months of age.
Pediatrics (January 2008)
Ruth Rose-Jacobs,
Maureen Black, Patrick Casey, John Cook, Diana Cutts, Mariana
Chilton, Timothy Heeren, Suzette Levenson, Alan Meyers, Deobrah
Frank
In this study, we evaluated the relationship between household food
security status and developmental risk in young children, after
controlling for potential confounding variables.