An extensive literature shows that psychosocial factors, low income levels, being Black, being a single head of household, and having children are the strongest predictors of household food insecurity. In a previous study of pregnant women in central North Carolina, those from food-insecure households had significantly lower income levels and less education and were more likely to be single and Black and to report higher perceived stress, anxiety, and depressive symptoms and lower self-esteem and mastery than women from food-secure households.
African-Americans experience household food insecurity at three times the rate of non-Hispanic Whites. Thirty percent of all African-American children and 40 percent of all low-income children live in food-insecure households. North Carolina is one of 10 States where household food insecurity is significantly higher (13.8 percent) than the national average (11 percent) and is one of 14 States that has had a significant increase in food insecurity since 1999. Concurrent with the North Carolina food insecurity statistics, almost 15 percent of North Carolina infants 0-2 years of age were overweight, defined as greater than the 85th percentile weight-for-height, in 2004.
The residual effect of the household experiencing food insecurity at a young age might influence eating behaviors, dietary intake, and weight status over time. For example, one study found that more adults who experienced past food insecurity tended to hoard food and be overweight compared with adults who did not. African-American first time mothers who are low-income are at a disproportionate risk of experiencing food insecurity. These mothers are also more likely to enter pregnancy at increased weight, gain excessive gestational weight, have gestational diabetes mellitus, and deliver an infant that is either under- or overweight for its gestational age.
This analysis was conducted as part of the Infant Care prospective cohort study that focused on risk factors of infant overweight born to first-time African-American mothers from low-income households in central North Carolina. Between 2003 and 2006, the Infant Care study enrolled 217 African-American mother/infant dyads. First-time mothers ages 18-35 and their 3-month-old infants were recruited mostly through local WIC clinics (Special Supplemental Nutrition Program for Women, Infants, and Children). Among the data collected at each time point were demographic data (household and caregiver), maternal and infant diet intake, maternal and infant anthropometric measurements, infant feeding styles, maternal depression, maternal self-esteem, neighborhood safety, and the six-item food security scale. Multinomial logistic regression was used to estimate the association between selected maternal/household characteristics and household food security status (food secure, marginally food secure, and food insecure).
The study found 53 percent of the women were from households characterized as food secure, 34 percent marginally food insecure, and 13 percent food insecure. The proportion of single mothers appears to decrease with increasing food insecurity, with food-insecure households having the lowest proportion of single mothers. Food-insecure households were more likely to have fathers in the household but were less likely to have a grandmother in the household. Very few households had both the baby’s father and maternal grandmother living together (8 percent). Also, none of the married women in the sample had grandmothers living in the household. Food-insecure households were more likely to be nuclear households and have smaller household sizes. Women from food-insecure households scored significantly higher on the depression scale, averaging 16 points, which corresponds to signs of clinical depression. Food-secure households had the highest mean self-esteem score compared with the other groups.
Multinomial logistic regression results showed that, compared with food-secure households, living with the child’s grandmother decreased the risk of food insecurity but living with the father and being depressed increased risk. Compared with food-secure households, having a college degree appeared to be protective against marginal food insecurity.
The study assessed the degree to which household food security status was associated with the infant outcomes: ever breastfed, ever put cereal in the bottle, ever giving juice before 3 months, mean calories per day, and infant weight and length at 3 months. The study found no association between marginal food security and any infant outcome. The study also found no association with food insecurity and inappropriate weaning practices (cereal in the bottle or juice before 3 months) or with infant weight at 3 months compared with food security. Results showed a significant association between food insecurity and ever breastfed, decreased mean calories per day, decreased infant length, controlling for maternal age, grandmother and father in the household, household size, education, ever worked, and depression score.
Findings from this study suggest that young low-income African-American families with their first child are particularly susceptible to experiencing household food insecurity. Having a grandmother in the household was protective against experiencing household food insecurity, while having the baby’s father in the household, as well as depressive symptoms, was associated with household food insecurity. Household food insecurity (but not marginal food security) was associated with having breastfed, decreased mean infant caloric intake, and infant length. Further longitudinal assessment of the effects of food insecurity on infant dietary intake and growth will help elucidate the role food insecurity has on weight over time.
Direct inquiries about this study to the Project Contact listed above.