Family socioeconomic status and maternal depressive symptoms: Mediation through household food insecurity across five years.

ABSTRACT

RATIONALE Food insecurity is a significant social problem that has been found to co-occur with both poverty and depression. However, few studies have utilized longitudinal data to investigate the associations among poverty, depression, and food insecurity. OBJECTIVE: This study tested two competing hypotheses, the food inadequacy hypothesis and the mental health hypothesis, in examining the associations among family socioeconomic status (SES), maternal depression, and household food insecurity across children's first five years of life. METHODS: Data were drawn from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a dataset nationally representative of all children born in the United States in 2001. Mothers reported family SES and household food insecurity when their children were nine months, 24 months, four years, and at kindergarten entry; maternal self-rated depressive symptoms were included at nine months, four years, and kindergarten entry. RESULTS: An autoregressive cross-lagged model showed that family SES was predictive of later household food insecurity, which in turn was associated with later maternal depressive symptoms. Significant mediation pathways were found with household food insecurity mediating the link between family SES and maternal depressive symptoms. CONCLUSIONS: This study highlights the need to consider household food insecurity as an underlying mechanism of maternal depressive symptoms in under-resourced families. Findings of this study can inform public health policy by highlighting the importance of considering factors such as food insecurity in the delivery of services to depressed mothers and their children in under-resourced contexts, and emphasizing the need for coordinated, integrated care in responding to the needs of these high-risk, vulnerable families.