Food Insecurity in Families with Children: Integrating Research, Practice, and Policy (Advances in Child and Family Policy and Practice) 3030743411, 9783030743413

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SPRINGER BRIEFS IN PSYCHOLOGY ADVANCES IN CHILD AND FAMILY POLICY AND PRACTICE

Barbara H. Fiese Anna D. Johnson   Editors

Food Insecurity in Families with Children Integrating Research, Practice, and Policy

SpringerBriefs in Psychology Advances in Child and Family Policy and Practice Series Editor Lisa A. Gennetian Institute for Human Development and Social Change New York University NY, USA

Advances in Child and Family Policy and Practice – a SpringerBriefs series published in affiliation with the Society for Child and Family Policy and Practice (Division 37 of the American Psychological Association) – serves as a forum for discussion of issues related to social policy and services for children, adolescents, and families with a psychosocial perspective. All Briefs deal with policy analyses and implications at various levels, including local, state, national, and international. Briefs may include literature and conceptual review papers; analyses of policy trends; evaluations of programs, policies, and systems; case examples of public and private policy issues; and advocacy needs, successes, and failures to demonstrate applications in which psychological expertise may be applied. Potential topics of interest also include organization of service programs; service delivery through different systems; and implementation, impact, and evaluation. A variety of child, youth, and family-related service programs and topics may be the focus of a Brief, including but not limited to: • • • • • • • •

Child mental health programs and policy Mental health screening/service needs Child welfare Child abuse and maltreatment Education, early childhood education and preK, and evaluation Health (including, integration of mental health within primary care and school Juvenile justice Racial/ethnic, socio-economic, or neighborhood/community disparities in services

service delivery, or in child, youth or family experiences All submissions are peer reviewed by the Editorial Board for substantive contribution to the psychological and policy literature related to issues of child and family practices. Briefs may consist of one longer manuscript on a topic or may be an integrated set of shorter papers. Each Brief should include literature reviews of the topics, the policy and practice implications of the topic, and a one- to two-page summary to be used for public advocacy. More information about this series at http://www.springer.com/series/11577

Barbara H. Fiese  •  Anna D. Johnson Editors

Food Insecurity in Families with Children Integrating Research, Practice, and Policy

Editors Barbara H. Fiese Department of Human Development & Family Studies University of Illinois at Urbana Champaign Champaign, IL, USA

Anna D. Johnson Department of Psychology Georgetown University Washington DC, WA, USA

ISSN 2192-8363     ISSN 2192-8371 (electronic) SpringerBriefs in Psychology ISSN 2625-2546 ISSN 2625-2554 (electronic) Advances in Child and Family Policy and Practice ISBN 978-3-030-74341-3    ISBN 978-3-030-74342-0 (eBook) https://doi.org/10.1007/978-3-030-74342-0 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Contents

Introducing the Issue ��������������������������������������������������������������������������������������    1 Barbara H. Fiese  Food Insecurity in Toddlerhood and School Readiness: Mediating Pathways Through Parental Well-Being and Behaviors������������   11 Anna J. Markowitz, Anna D. Johnson, and Caitlin T. Hines  The Consequences of Food Insecurity for Children with Disabilities in the Early Elementary School Years ������������������������������   33 Kevin A. Gee  Early Childhood WIC Receipt and Cognitive and Socioemotional Outcomes at School Entry and Middle Childhood������������������������������������������������������������������������������������   55 Caitlin T. Hines and Rebecca Ryan  Food Insecurity in Households with Adolescents: Links to Youth Mental Health������������������������������������������������������������������������   77 Anna Gassman-Pines, William E. Copeland, Rick H. Hoyle, and Candice L. Odgers  The Role of the Supplemental Nutrition Assistance Program in Addressing Negative Outcomes Associated with Food Insecurity����������������������������������������������������������������������������������������   95 Craig Gundersen Index������������������������������������������������������������������������������������������������������������������  103

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Contributors

William E. Copeland  University of Vermont, Burlington, VT, USA Barbara H. Fiese  University of Illinois at Urbana Champaign, Champaign, IL, USA Anna Gassman-Pines  Duke University, Durham, NC, USA Kevin A. Gee  University of California, Davis, Davis, CA, USA Craig Gundersen  University of Illinois, Champaign, IL, USA Caitlin T. Hines  Georgetown University, Washington, DC, USA Rick H. Hoyle  Duke University, Durham, NC, USA Anna D. Johnson  Georgetown University, Washington, DC, USA Anna J. Markowitz  University of California, Los Angeles, Los Angeles, CA, USA Candice L. Odgers  University of California-Irvine, Irvine, CA, USA Rebecca Ryan  Georgetown University, Washington, DC, USA

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About the Authors

William E. Copeland  is a Professor of Psychiatry and the Director of Research in the Vermont Center for Children, Youth and Families at the Larner College of Medicine at the University of Vermont. His research program has focused on understanding the development of emotional and behavior health across the lifespan. This work includes understanding the interplay between early adverse experiences and genetic vulnerability with other individual, family, and contextual characteristics. Barbara  H.  Fiese  is Professor of Human Development and Family Studies, Emerita, and the Pampered Chef Endowed Chair in Family Resiliency, Emerita, at the University of Illinois at Urbana-Champaign. She served as the Director of the Family Resiliency Center from 2008 to 2020. She is considered one of the national experts on the role that shared family meals may play in promoting health. She is a principal investigator (PI) or co-investigator on multiple federally funded projects aimed at examining environmental and biological factors contributing to early nutritional health. She is also the PI on several projects aimed at increasing the efficiencies of summer and after school feeding programs for food insecure children and youth. Anna  Gassman-Pines  is WLF Bass Connections Associate Professor in the Sanford School of Public Policy at Duke University and a faculty affiliate of the Duke Center for Child and Family Policy. Her research focuses on the development of low-income children in the United States and, in particular, how parents’ experiences outside the home—in low-wage workplaces, labor markets, accessing social services—spillover to the home and affect family functioning and child well-being. Kevin A. Gee  is an Associate Professor in the School of Education at the University of California, Davis. His research expertise focuses on how school policies and programs promote the well-being and educational outcomes of vulnerable youth who face a broad array of adverse conditions and experiences including school bullying, food insecurity, and abuse and neglect. He asks policy-relevant questions critical to understanding how their experiences of adversity influence their ix

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schooling-­related outcomes; and how school policies and programs can enhance their well-being and educational outcomes. Craig Gundersen  is a Professor of Agricultural and Consumer Economics at the University of Illinois at Urbana-Champaign. He holds the ACES Distinguished Professorship and is the Director of Undergraduate Studies. Dr. Gundersen informs policy makers and program administrators who are seeking paths to reduce food insecurity and its consequences. Due to the serious health consequences, food insecurity has become one of the leading health care crises in the United States. Using data from nationally representative data sets, he analyzes the causes and consequences of food insecurity and evaluates food assistance programs, with a particular emphasis on the Supplemental Nutrition Assistance Program (SNAP). Caitlin  T.  Hines  is a doctoral student in the Department of Psychology at Georgetown University. She is a member of the Child Development and Social Policy Lab, where her research focuses on the role of parental investments and biological vulnerabilities on children’s school readiness and how they vary based on socioeconomic status.  Additionally, she studies the relationship between childhood food insecurity, food assistance programs, and children’s non-health outcomes. Caitlin holds a Master’s in Public Policy from Georgetown University. Rick H. Hoyle  is Professor of Psychology and Neuroscience and Director of the Center for the Study of Adolescent Risk and Resilience at Duke University. His research focuses on the capacities and skills that support autonomous goal pursuit, with a particular focus on the pursuit of long-term goals relevant for psychological health and well-being. Anna D. Johnson  is an Associate Professor in the Department of Psychology at Georgetown University. She co-directs Georgetown’s Child Development and Social Policy Lab and is a Research Fellow at Child Trends in Washington, DC. Dr. Johnson’s research focuses on evaluating policy solutions designed to enhance low-­ income children’s development and school readiness, such as publicly funded child care and pre-kindergarten programs. Dr. Johnson also studies food insecurity as a threat to the healthy development and school readiness of low-income children. Anna J. Markowitz  is an Assistant Professor in the Graduate School of Education and Information Sciences at the University of California, Los Angeles. In her research she uses quantitative methods to investigate how children’s early experiences shape their cognitive and socioemotional development and how policy influences the contexts children spend time in. Dr. Markowitz is particularly interested in programs and policies designed to ameliorate early educational disparities, and in the ways in which policies impact the caregivers children rely on, with a particular emphasis on the overall well-being and food security of children’s parents and teachers.

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Candice L. Odgers  is a Professor of Psychological Science at the University of California Irvine and Co-Director of the Child & Brain Development Program at the Canadian Institute for Advanced Research. Her research focuses on how early experiences and social inequalities influence child and adolescent development, with an emphasis on how digital technologies can be leveraged to support mental health. Rebecca Ryan  is a Provost’s Distinguished Associate Professor in the Department of Psychology at Georgetown University. Most broadly, her research explores the implications of low income for children’s home environments as well as the relationship between parenting and children’s development in at-risk contexts. Both strains of research explore two fundamental influences on child well-being: the quality of parent-child interactions and parents’ ability to invest time and money in children’s environments.

Introducing the Issue Barbara H. Fiese

Food insecurity, or having access to enough food to live an active healthy lifestyle, affects close to 30% of low-income households with young children (Coleman-­ Jensen et al., 2019). In 2018, 11.2 million children (1 in 7) lived in a food insecure household. With the onslaught of the coronavirus in 2020, there are dire predictions about a substantial increase in food insecurity in households with children. Feeding America, a nationwide network of food banks, estimates that there will be a total of between 12.4 million and 18.0 million children living in food insecure households in the United States by the end of 2020 (Hake et al., 2020). Thus, food insecurity is a public health issue of grave concern. This brief will synthesize current knowledge about food insecurity’s effects on children, families, and households and will emphasize multiple pathways and variations across developmental contexts. This volume also focuses on emerging new methods that allow for a more refined approach to inform practice and policy. This introduction provides a brief overview of the major research themes in food insecurity in households with children, and how this volume addresses significant gaps in the literature. We will focus our attention on food insecurity in the United States. Although the effects of food insecurity on children are a global issue, there may be noticeable differences in other regions of the world where malnutrition (stunting and wasting) is a more unfortunate outcome for children than in the United States (Moradi et al., 2019).

B. H. Fiese (*) Department of Human Development and Family Studies, University of Illinois at Urbana Champaign, Champaign, IL, USA e-mail: [email protected]

© The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 B. H. Fiese, A. D. Johnson (eds.), Food Insecurity in Families with Children, Advances in Child and Family Policy and Practice, https://doi.org/10.1007/978-3-030-74342-0_1

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Scope of the Problem According to the latest report issued by the United States Department of Agriculture, in 2018, 13.9% of all households with children experienced food insecurity, 14.3% of households with children under the age of 6, and 27.8% of households with children headed by a single woman (Coleman-Jensen et al., 2019). Although these numbers represent a modest decline in food insecurity rates for households with children from the previous year, more than 11 million children in the United States that year did not have adequate sources of food to lead a healthy active lifestyle. As noted above, food insecurity has increased and is expected to continue to increase as the COVID-19 pandemic persists. In addition to nutritional concerns, experiencing food insecurity can compromise the health, social development, and academic performance of children and youth.

Health Consequences Infants and toddlers who experience food insecurity are at greater risk for neurocognitive difficulties and poor developmental outcomes (Cook & Frank, 2008). In a large study of over 40,000 children under the age of 4, the Children’s Health Watch team has documented the effects of food insecurity on children’s health. Even marginal food insecurity was associated with adverse health outcomes including poor health, child hospitalizations, and admissions to the emergency department (Cook et al., 2004). One study found that, controlling for household income, children who were raised in food insufficient households (family sometimes or often did not get enough to eat) were more likely to have poorer health overall, experience more stomachaches and headaches, and have more frequent colds than children raised in food sufficient households (Alaimo et al., 2001). In a nationally representative interview study of over 29,000 families with children between 2 and 17 years of age, household food insecurity was related to overall poorer health (Thomas et al., 2019). Specifically, children raised in food insecure households had higher rates of asthma, depressive symptoms, and emergency room use (Thomas et al., 2019). There is also some indication that children raised in food insecure households have poorer oral health (Hill, 2020) and are at risk for iron-deficiency anemia (Park et al., 2009), high blood pressure (South et  al., 2019), and prediabetes risk in adolescents (Lee et al., 2019). A health concern for children raised in food insecure households is risk for being overweight or obese. This concern stems from the expectation that inadequate sources of food results in poor diet quality, often high in fat and low in nutrient-­dense foods. The findings from large-scale studies have been somewhat mixed. For example, Casey and colleagues reported that the prevalence of overweight and obese children between 3 and 17 years in the nationally representative NHANES 1999–2002 sample was 28.8% in food secure households in comparison

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to 38.8% in food insecure households (Casey et  al., 2006). However, in a more detailed analysis of the same sample, Gundersen and colleagues reported that when focusing on low-income families, overweight was not associated with food security for the 3- to 10-year olds or 11–17 year olds. However, there were significant interactions between maternal stress and risk for being overweight for the 3- to 10-year olds (Gundersen et al., 2008). In an examination of the 2001–2004 NHANES dataset, multiple indicators of overweight and obesity were examined including body mass index (BMI), waist circumference, triceps fold, trunk fat mass, and percentage of body fat. Again, no relation between food security and multiple measures of obesity risk was found for 8- to 17-year olds (Gundersen et al., 2009). However, there are important moderators of these effects including maternal stress and depression. More recent reports of children between birth and 48 months of age have not find elevated rates of obesity in children raised in food insecure households, with the exception of the 25- to 36-month age range (Drennen et al., 2019). However, no differences were found at 48 months. It should be pointed out that these are cross-­ sectional data and it is difficult to determine true trends without longitudinal data and dietary habits. There have also been reports that infants raised in very low food insecure households are at increased risk for being overweight in comparison to infants raised in food secure households. No such differences were found for infants raised in low food secure households (Benjamin Neelon et al., 2020). There have been some noted sex differences in overweight and obesity risk for children raised in food insecure households. Tan and colleagues found that 9- to 11-year-old girls raised in food insecure households consumed more calories than girls raised in food secure households. No differences were found for boys (Tan et al., 2019). Using the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) dataset and a modified version of the USDA food security scale (including households that responded affirmatively to >1 item in the past year), Jyoti and colleagues report that girls, not boys, evidenced greater BMI and weight gain from kindergarten to third grade (Jyoti et al., 2005). In a longitudinal report examining growth in BMI from kindergarten through eighth grade, Burke and colleagues found that for girls raised in food insecure households there was an increase in BMI growth by 2.87% in comparison to girls raised in food secure households by the eighth grade (Burke, Frongillo, et al., 2016). No such differences were found for boys. It should be noted that these researchers measured growth in raw BMI scores, not standardized BMI z scores or obesity. To summarize, there are several documented health consequences of being raised in a food insecure household. Lack of access to food for a healthy lifestyle places children at risk for chronic health conditions such as asthma, heart disease, prediabetes, and compromised neurodevelopmental functioning. The direct effect on childhood obesity is more mixed, however, as girls may be more at risk for overweight than boys raised in food insecure households.

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Social and Academic Consequences There is evidence that experiencing food insecurity has consequence for social and academic outcomes. Two decades ago, Alaimo and colleagues documented that children and adolescents who experienced food insufficiency (i.e., their families sometimes or often did not get enough food to eat) scored lower on academic tests, were more likely to repeat a grade (children) or be suspended from school (adolescents), see a psychologist, and have difficulty getting along with other children (Alaimo et  al., 2001). Jyoti and colleagues documented similar outcomes in that children raised in food insecure households gained smaller increases in mathematics and reading scores and had a greater decline in social skills as reported by their teachers (Jyoti et al., 2005). Recent evidence suggests that children raised in food insecure households are less prepared to enter kindergarten, performing poorer on reading and math tests and showing signs of hyperactivity, conduct problems, and compromised approaches to learning (Johnson & Markowitz, 2018). Food insecurity is also associated with internalizing problems in adolescents across time (Whitsett et al., 2019).

Systemic Factors Domestic food insecurity occurs in social and economic contexts affecting families in ways that are often out of their control. For example, in 2008 at the time of the Great Recession, there was a sharp increase in the prevalence of food insecurity. Although there has been a decrease in the rates over the past 2 years, they have not returned to the prerecession rates (Coleman-Jensen et  al., 2019). In addition, the COVID-19 pandemic is expected to have long-term effects on unemployment that, in turn, will effect rising rates of household food insecurity (Hake et al., 2020). Housing instability is associated with higher rates of food insecurity. In the Children’s Health Watch Study, close to half of households report being behind on rent, experiencing multiple moves, or being homeless also reported being food insecure in comparison to 19% of those who reported stable housing (Sandel et  al., 2018). Family structure may also play a role. Children raised in single-parent households are at increased risk for being food insecure, even when controlling for income level (Balistreri, 2018). Children raised with their biological parents in comparison to cohabitating parents are less likely to be food insecure (Balistreri, 2018). Controlling for income, households with teenagers are more likely to be very low food insecure (Anderson et al., 2016). Although these factors may be considered confounds in a statistical sense, they are also indicators of the lived experience of families experiencing food insecurity who may be resource poor in multiple ways. There is consistent evidence that food insecurity can place added stress and strain on parents. Maternal stress, depression, and anxiety may disrupt positive parenting practices. Cross-sectional studies have documented that mothers who are food insecure are more likely to experience prenatal depression (Hromi-Fiedler et al., 2011),

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depressive symptoms (Garg et al., 2015), and major depressive episodes and anxiety disorders (Whitaker et  al., 2006). Longitudinal studies with large representative datasets indicate that maternal depression at 9-month postpartum is associated with both child and household food insecurity at 2 years of age (Garg et  al., 2015). Although these factors are not proposed to cause food insecurity, they are often considered important mediators of the effects on consequences on children’s development. There is also the developmental context to food insecurity to consider. Experiencing food insecurity as an infant and toddler can have long-term consequences for outcomes such as developmental delays and cognitive functioning (Rose-Jacobs et al., 2008; Zaslow et al., 2009). During the transition to kindergarten, children who experienced food insecurity during infancy and toddlerhood are at increased risk for poor reading, math, and socio-emotional skills essential for success in the later elementary school years (Johnson & Markowitz, 2018). As children mature cognitively, they become increasingly aware of the family’s food situation and may take personal responsibility to attain food (Fram et al., 2011). It is probable that there are long-term consequences of feeling personally responsible for managing the family’s food environment as a large longitudinal study has documented that as adolescents raised in food insecure households transition to adulthood they experience elevated levels of psychological distress (Heflin et al., 2019).

Gaps in the Literature and What This Brief Has to Offer Although there have been significant strides in the empirical literature over the past 20 years documenting the harmful effects of being raised in a food insecure household on child development, there are still notable gaps. Primary among the limitations of the literature is a focus on single predictors of parenting behaviors without considering a family systems approach and multiple factors that may contribute to child outcomes over time. A second limitation is the failure to extend studies to underrepresented populations who might be at increased risk for experiencing food insecurity. Third, there is a gap in our understanding of how families move in and out of food insecurity and month-to-month variations that may account for why some low-income families experience food insecurity and others do not. Fourth, there is the need to apply findings to actionable steps for policy and practice. The chapters in this brief address each one of these limitations to one degree or another. In chapter “Food Insecurity in Toddlerhood and School Readiness: Mediating Pathways Through Parental Wellbeing and Behaviors”, Markowitz, Johnson, and Hines expand the literature by considering mediating effects of parenting behaviors from toddlerhood in predicting school readiness during the transition to kindergarten. They identify parenting stress as an important behavior that mediates food insecurity and math and reading skills. This is an important finding for two reasons. First, it expands previous research linking depressive symptoms to food insecurity (which the authors also found) to a more likely prevalent parenting

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experience—stress. Second, it points to possible areas of prevention that can be delivered through publicly funded programs such as the Women Infants and Children (WIC) program and the Supplemental Nutrition Assistance Program (SNAP) in partnership with home visitation programs that have proven to reduce parenting stress (Ferguson & Vanderpool, 2013; Radcliff et al., 2018). In chapter “The Consequences of Food Insecurity for Children with Disabilities in the Early Elementary School Years”, Gee applies the Family Stress Model (FSM) (Masarik & Conger, 2017) to better understand how food insecurity affects households with children with disabilities. Given that households with a member with a disability are disproportionally affected by food insecurity (Coleman-Jensen & Nord, 2013), the majority of research has focused on adults with disabilities with some notable exceptions (Rose-Jacobs et al., 2016). Gee points out that economic pressures on the family level (financial strain due to higher medical costs, potential need to accommodate special diets, increased costs for transportation for medical appointments) may have consequences for children with disabilities, particularly at stressful developmental transition points such as the early elementary school years. He demonstrates that food insecurity was consistently related to children’s attention decline in attentional focus but not for behavior problems (internalizing and externalizing). These findings advance the field by identifying not only the relation between food insecurity and important outcomes for children with disabilities but for its precision in terms of what outcomes are affected under what conditions. In chapter “Early Childhood WIC Receipt and Cognitive and Socioemotional Outcomes at School Entry and Middle Childhood”, Hines and Ryan address the potential for WIC to have an impact on nondevelopmental outcomes. Although there is a solid literature base documenting the effects of WIC on reducing food security rates in early childhood (Kreider et al., 2016), less attention has been paid to effects beyond early childhood. This chapter expands the literature by considering the effects of WIC on cognitive and socio-emotional skills of siblings who did and did not receive WIC at school entry and middle childhood. The inclusion of siblings who did or did not receive the program is a particularly strong approach as it reduces selection effects. The researchers found that WIC did show a protective effect for behavioral problems at school entry. However, these effects faded at middle school. There were no effects on cognitive skills. Although the authors recognize some of the limitations of the sibling fixed effect approach, it does point to important questions such as the cumulative effect of having multiple siblings enrolled in WIC, why do some families choose to enroll only one sibling in the household in WIC, and the effects of having a younger sibling enrolled in WIC on older siblings? These are important questions for future research. The authors conclude that in the era of COVID-19, it will be even more important for federal programs such as WIC and SNAP to increase their support of children’s health and nutrition as rates of food insecurity are expected to rise. In chapter “Food Insecurity in Households with Adolescents: Links to Youth Mental Health”, Gassman-Pines and colleagues provide a developmental perspective on food insecurity and address an important gap in the literature by including adolescent and parent perspectives on food insecurity. Although some attention has been paid to mental health outcomes in adolescents who are food insecure (Burke,

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Martini, et  al., 2016), less attention has been paid to general well-being or risk behaviors such as substance abuse. This chapter addresses these gaps as well as including both parent and adolescent report of food insecurity. The authors found that parents and adolescents tend to agree on the status of food insecurity in the household, although there were some exceptions. Both adolescent and parent reports of food insecurity were related to adolescent psychological distress. These findings are important as they point to avenues of intervention and prevention. As adolescents can play an important role in managing food resources and contributing to the economic resources of the home, it is critical to consider how their well-being is protected so they can fully contribute to the household without undue stress. Potential avenues for support might include being a paid worker in federally funded food programs such as the Summer Food Service Program (SFSP) and after-school feeding programs (CACFP). The final chapter by Gundersen provides an overview of federally funded programs such as SNAP that have a positive effect on food insecure households. He concludes that adequate support for this program is essential for the health of American families. Food insecurity is a public health concern of monumental proportion. If the projections are correct that close to 18 million children will experience inadequate access to food to lead a healthy lifestyle as a result of COVID-19, then the consequences to health, academic performance, and social development are equally dire. However, there is room for optimism. As outlined in this volume, support for federal programs such as WIC, SNAP, SFSP, and CACFP can ameliorate some of the consequences of food insecurity on children’s health and well-being. A more comprehensive approach is also called for that extends beyond the provision of food. Schools play a pivotal role in distributing food to children through the National School Breakfast Program and the National School Lunch Program as well as coordinating SFSP. They also serve as a resource for mental health services. Coordinated efforts between food service programs and support for mental health outreach programs will be essential in protecting children’s health and well-being. Collectively, the chapters in this volume point to the need to consider the multiple influences on children and youth outcomes when raised in food insecure households including access to transportation, support from federal programs, access to mental and physical health programs, and economic strain at the household level. With this broad approach, children and youth may be better served and food insecurity reasonably reduced.

References Alaimo, K., Olson, C. M., & Frongillo, E. A. (2001). Food insufficiency and American school-­ aged children’s cognitive, academic and psychosocial development. Pediatrics, 108, 44–53. Alaimo, K., Olson, C. M., Frongillo, E. A., & Briefel, R. R. (2001). Food insufficiency, family income, and health in US preschool and school-aged children. American Journal of Public Health, 91, 781–786. https://doi.org/10.2105/ajph.91.5.781

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Anderson, P. M., Butcher, K. F., Hoyners, H. W., & Schanzenbach, D. W. (2016). Beyond income: What else predicts very low food security among children? Southern Economic Journal, 82, 1078–1105. https://doi.org/10.1002/soej.12079 Balistreri, K.  S. (2018). Family structure and child food insecurity: Evidence from the current polpulation survey. Social Indicators Research, 138, 1171–1185. https://doi.org/10.1007/ s11205-­017-­1700-­7 Benjamin Neelon, S. E., Allen, C., & Neelon, B. H. (2020). Household food insecurity and infant adiposity. Pediatrics, 143, e20193725. https://doi.org/10.1542/peds.2019-­3725 Burke, M. P., Frongillo, E. A., Jones, S. J., Bell, B. B., & Hartline-Grafton, H. L. (2016). Household food insecurity is associated with greater growth in Body Mass Index among female children from kindergarten through eighth grade. Journal of Hunger & Environmental Nutrition, 11, 227–241. https://doi.org/10.1080/19320248.2015.1112756 Burke, M. P., Martini, L. H., Cayir, E., Hartline-Grafton, H. L., & Meade, R. L. (2016). Severity of household food insecurity is positively associated with mental disorders among children and adolescents in the United States. The Journal of Nutrition, 146, 2019–2026. https://doi. org/10.3945/jn.116.232298 Casey, P. H., Simpson, P. M., Gossett, M. L., Bogle, M. L., Champagne, C. M., Harsha, D., … Weber, J. (2006). The association of child and household food insecurity with childhood overweight status. Pediatrics, 118, e1406–e1403. https://doi.org/10.1542/peds.2006-­0097 Coleman-Jensen, A., & Nord, M. (2013, January 1). Food insecurity among households with working-age adults with disabilities. (ERR-144). United States Department of Agriculture. Economic Research Service. https://doi.org/10.2139/ssrn.2202869 Coleman-Jensen, A., Rabbitt, M. P., Gregory, C., & Singh, A. (2019, September). Household food insecurity in the United States in 2018. (ERR-270). United States Department of Agriculture. Economic Research Service. Cook, J. T., & Frank, D. A. (2008). Food security, poverty, and human development in the United States. Annals of the New York Academy of Sciences, 1136, 193–209. https://doi.org/10.1196/ annals.1425.001 Cook, J.  T., Frank, D.  A., Berkowitz, C., Black, M.  M., Casey, P.  H., Cutts, D.  B., … Nord, M. (2004). Food insecurity is associated with adverse health outcomes among human infants and toddlers. Journal of Nutrition, 134, 1432–1438. https://doi.org/10.1093/jn/134.6.1432 Drennen, C. R., Coleman, S. M., Ettinger de Cuba, S., Frank, D. A., Chilton, M., Cook, J. T., … Black, M.  M. (2019). Food insecurity, health, and development in chidlren under age four years. Pediatrics, 144, e20190824. https://doi.org/10.1542/peds.2019-­0824 Ferguson, J. M., & Vanderpool, R. C. (2013). Impact of a Kentucky maternal, infant, and early childhood Home-Visitation Program on parental risk factors. Journal Child and Family Studies, 222, 551–558. https://doi.org/10.1007/s10826-­012-­9610-­4 Fram, M.  S., Frongillo, E.  A., Jones, S.  J., Williams, R.  C., Burke, M.  P., DeLoach, K.  P., & Christine, E.  B. (2011). Children are aware of food insecurity and take responsibility for managing food resources. Journal of Nutrition, 141, 1114–1119. https://doi.org/10.3945/ jn.110.135988 Garg, A., Toy, S., Tripodis, Y., Cook, J., & Cordella, N. (2015). Influence of maternal depression on household food insecurity for low-income families. Academic Pediatrics, 15, 305–310. https:// doi.org/10.1016/j.acap.2014.10.002 Gundersen, C., Garasky, S., & Lohman, B.  J. (2009). Food insecurity is not associated with childhood obesity as assesed using multiple measures of obesity. Journal of Nutrition, 139, 1173–1178. https://doi.org/10.3945/jn.109.105361 Gundersen, C., Lohman, B. J., Garasky, S., Stewart, S., & Eisenmann, J. (2008). Food secuirty, maternal stressors, and overweigth among low-income US Children: Results from the National Health and Nutrition Examination Survey (1999-2002). Pediatrics, 122, e529–e540. https:// doi.org/10.1542/peds.2008-­0556 Hake, M., Englehard, E., Dewey, A., & Gundersen, C. (2020). The impact of the coronavirus on child food insecurity. Retrieved from https://www.feedingamerica.org/sites/default/files/2020­04/Brief_Impact%20of%20Covid%20on%20Child%20Food%20Insecurity%204.22.20.pdf

Introducing the Issue

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Heflin, C., Kukla-Acevedo, S., & Darolia, R. (2019). Adolescent food insecurity and risky behaviors and mental health during the transition to adulthood. Children and Youth Services Review, 105, 104416. https://doi.org/10.1016/j.childyouth.2019.104416 Hill, B. (2020). Evaluating the association between food insecurity and dental caries in US children 1-19 years: Results from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Journal of Public Health Dentistry, 80(1), 14–17. https://doi.org/10.1111/ jphd.12345 Hromi-Fiedler, A., Bermudez-Milan, A., Segura-Perez, S., & Perez-Escamilla, R. (2011). Household food insecurity is associated with depressive symptoms in lowincome pregnant Latinas. Maternal and Child Nutrition, 7, 421–430. https://doi. org/10.1111/j.1740-­8709.2010.00266.x Johnson, A. D., & Markowitz, A. J. (2018). Associations between household food insecurity in early childhood and children’s kindergarten skills. Child Development, 89, e1–e17. https://doi. org/10.1111/cdev.12764 Jyoti, D.  F., Frongillo, E.  A., & Jones, S.  J. (2005). Food insecurity affects school children’s academic performance, weight gain, and social skills. Journal of Nutrition, 135, 2831–2839. https://doi.org/10.1093/jn/135.12.2831 Kreider, B., Pepper, J. V., & Roy, M. (2016). Identifying the effects of WIC on food insecurity among infants and children. Southern Economic Journal, 82(4), 1106–1122. https://doi. org/10.1002/soej.12078 Lee, A. M., Scharf, R. J., Fliipp, S. L., Gurka, M. J., & DeBoer, M. D. (2019). Food insecurity is associated with prediabetes risk among U.S. adolescents, NHANES 2003-2014. Metabolic Syndrome and Related Disorders, 17, 347–354. https://doi.org/10.1089/met.2019.0006 Masarik, A.  S., & Conger, R.  D. (2017). Stress and child development: A review of the family stress model. Current Opinion in Psychology, 13, 85–90. https://doi.org/10.1016/j. copsyc.2016.05.008 Moradi, S., Mirzababaei, A., Mohammadi, H., Moosavian, S. P., Arab, A., Jannat, B., & Mirzaei, K. (2019). Food insecurity and the risk of undernutrition complications among children and adolescents: A systematic review and meta-analysis. Nutrition, 62, 52–60. https://doi. org/10.1016/j.nut.2018.11.029 Park, K., Kersey, M., Geppert, J., Story, M., Cutts, D.  B., & Himes, J.  H. (2009). Household food insecurity is a risk factor for iron-deficiency anemia in a multi-ethnic, low-income sample of infants and toddlers. Public Health Nutrition, 12, 2120–2128. https://doi.org/10.1017/ S1368980009005540 Radcliff, E., Gustafson, E., Crouch, E., & Bennett, K. J. (2018). Uptake of Supplemental Nutrition Assistance Program benefits by participants in a home visiting program. Social Work, 63, 244–251. https://doi.org/10.1093/sw/swy022 Rose-Jacobs, R., Black, M.  M., Casey, P.  H., Cook, J.  T., Cutts, D.  B., Chilton, M., … Frank, D. A. (2008). Household food insecurity: Associations with at-riks infant and toddler development. Pediatrics, 121, 65–72. https://doi.org/10.1542/peds.2006-­3717 Rose-Jacobs, R., Fiore, J. G., Ettinger de Cuba, S., Black, M. M., Cutts, D. B., Coleman, S., … Frank, D. A. (2016). Children with special health care needs, supplemental security income, and food insecurity. Journal of Developmental and Behavioral Pediatrics, 37, 140–147. https:// doi.org/10.1097/DBP/0000000000000260 Sandel, M., Sheward, R., Ettinger de Cuba, S., Coleman, S. M., Frank, D. A., Chilton, M., … Cutts, D. B. (2018). Unstable housing and caregiver and child health in renter families. Pediatrics, 141, e20172199. https://doi.org/10.1542/peds.2017-­2199 South, A. M., Palakshappa, D., & Brown, C. L. (2019). Relationship between food insecurity and high blood pressure in a national sample of children and adolescents. Pediatric Nephrology, 34, 1583–1590. https://doi.org/10.1007/s00467-­019-­04253-­3 Tan, M. L., Laraia, B., Madsen, K. A., Au, L. E., Frongillo, E. A., & Ritchie, L. (2019). Child food insecurity is associated with energy intake among fourth- and fifth- grade girls. Journal of Academy Nutrition and Dietetics, 119, 1722–1731. https://doi.org/10.1016/jand.2018.07.011

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Thomas, M. M. C., Miller, D. P., & Morrissey, T. W. (2019). Food insecurity and child health. Pediatrics, 144, e20190397. https://doi.org/10.1542/peds.2019-­0397 Whitaker, R. C., Phillips, S. M., & Orzol, S. M. (2006). Food insecurity and the risks of depression and anxiety in mothers, and behavior problems in their preschool-aged children. Pediatrics, 118, e859–e868. https://doi.org/10.1542/peds.2006-­0239 Whitsett, D., Sherman, M. F., & Kotchick, B. (2019). Household food insecurity in early adolescence and risk of subsequent behavior problems: Does a connection persist over time? Journal of Pediatric Psychology, 44, 478–489. https://doi.org/10.1093/jpepsy/jsy088 Zaslow, M., Bronte-Tinkew, J., Capps, R., Horowitz, A., Moore, K. A., & Weinstein, N. D. (2009). Food security during infancy: Implications for attachment and mental profiency in toddlerhood. Maternal and Child Health Journal, 13, 66–80.

Food Insecurity in Toddlerhood and School Readiness: Mediating Pathways Through Parental Well-Being and Behaviors Anna J. Markowitz, Anna D. Johnson, and Caitlin T. Hines

 ood Insecurity in Toddlerhood and School Readiness: F Mediating Pathways Through Parental Well-Being and Behaviors The arrival of COVID-19 dramatically increased rates of food insecurity—or the lack of access to sufficient food needed to fuel a healthy and active life (Coleman-­ Jensen et al., 2019). By the summer of 2020, nearly one in three households with children in the United States was experiencing food insecurity. These rates are higher among low-income households with young children (aged 0–5); it is thus especially worrisome that food insecurity in early childhood has been linked with reductions in the foundational cognitive, social, and emotional skills (Johnson & Markowitz, 2018a) that support later academic success (e.g., Claessens et al., 2009). Given the staggering prevalence of food insecurity and the established links between food insecurity in early childhood and increased health and developmental risks (Johnson & Markowitz, 2018a; Rose-Jacobs et  al., 2008; Shankar et  al., 2017; Whitaker et al., 2006), it is not surprising that food insecurity is considered one of the major ways COVID-19 may have long-lasting developmental impacts. Recognition of the prevalence of food insecurity, even prior to COVID-19, and its associated developmental risks has intensified research efforts to identify the mechanisms that may transmit food insecurity’s negative sequalae to young children. Some prior research has hypothesized a direct pathway—via nutrition—from A. J. Markowitz (*) University of California, Los Angeles, Los Angeles, CA, USA e-mail: [email protected] A. D. Johnson · C. T. Hines Department of Psychology, Georgetown University, Washington, DC, USA e-mail: [email protected]; [email protected]

© The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 B. H. Fiese, A. D. Johnson (eds.), Food Insecurity in Families with Children, Advances in Child and Family Policy and Practice, https://doi.org/10.1007/978-3-030-74342-0_2

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food insecurity to poor child health and developmental outcomes, but other research highlights the potential for mediating factors beyond nutritional deprivation (Jyoti et al., 2005; Leung et al., 2020). This work points to parental well-being and behavior as promising, policy-amenable mechanisms linking food insecurity to early development. To date, the majority of that research has focused on maternal depression (e.g., Garg et al., 2015; Zaslow et al., 2009), to the exclusion of other indicators of parent well-being and behavior factors such as parenting stress, spouse or partner interactions, and cognitively stimulating parent–child interactions. The current study explores these understudied potential indirect pathways from a household measure of food insecurity to very young children’s development in a sample of low-income families. Using a large, nationally representative dataset, we explore whether and to what extent the established negative relationship between food insecurity in very early childhood (that is, between 9 months and 2 years old) and children’s kindergarten skills may be mediated by a larger set of parental well-­ being and behavior factors than has been previously studied. In doing so, we contribute to active child and family policy and practice debates around identifying malleable family factors that, if addressed via food assistance or other community resources, could reduce potential harmful effects of food insecurity on children.

Household Food Insecurity and Children’s Development A growing body of research links household food insecurity to child well-being and development among school-age children (e.g., Melchior et al., 2014; Slopen et al., 2010) as well as among children aged 0–5 (e.g., Johnson & Markowitz, 2018a). Given that early childhood is a key developmental period for promoting long-term well-being, the well-documented negative associations between food insecurity in children’s first few years and their early outcomes are troubling. Among young children, food insecurity predicts increased internalizing and externalizing behavior problems (Slack & Yoo, 2005; Whitaker et  al., 2006), including hyperactivity, aggression, and anxiety (Melchior et al., 2014; Whitaker et al., 2006). Food insecurity is also associated with lower cognitive skills (Hernandez & Jacknowitz, 2009). For example, Zaslow et  al. (2009) showed that food insecurity at 9 months was indirectly associated with children’s cognitive scores at age two via maternal depression. Pathways proposed to explain the negative associations between food insecurity and developmental outcomes among very young children include a pathway through nutritional deprivation and child health, pathways through child well-being, and a pathway through disruptions in parental and family well-being and functioning, which interferes with quality caregiving (e.g., Ashiabi & O’Neal, 2008; Belsky et al., 2010). With respect to the nutrition pathway, there is evidence that moderate nutritional deficiencies during a child’s first few years can disrupt the development of foundational brain processes and structures (e.g., Knickmeyer et al., 2008; Tanner & Finn-Stevenson, 2002), and there is some evidence that food insecurity is linked

Food Insecurity in Toddlerhood and School Readiness…

13

to such deficits (e.g., Park et al., 2009; Skalicky et al., 2006). These disruptions can in turn impede core cognitive and self-regulatory functioning, as well as memory, attention, and behavior (e.g., Grantham-McGregor & Ani, 2001; Halterman et al., 2001), which may have long-lasting developmental implications. While nutritional deprivation may explain some of the documented negative links between food insecurity and child outcomes, in the context of the U.S., it is unlikely to be either the sole or strongest explanatory pathway (Jyoti et al., 2005; Leung et al., 2020). Research from Fram and colleagues highlights the importance of school-aged children’s own psychological responses to food insecurity (e.g., Fram et al., 2011). Among very young children (aged 0–5) in particular, research has suggested that parental pathways may serve as a strong link between household food insecurity and child development.

 ousehold Food Insecurity and Parent Well-Being H and Behaviors Parents are often children’s earliest playmates and teachers, and it is widely accepted that parent well-being and behaviors matter for early development. A large literature links maternal depression, parenting stress, and interparental conflict to suboptimal child outcomes (e.g., Grych, 2002; Surkan et al., 2012), while supportive, responsive parent–child interactions, including attending to children’s distress, asking questions and modeling complex language, and daily reading, are predictive of enhanced skill development (Bradley et al., 2001; Petrill & Deater-Deckard, 2004; Thompson & Lagattuta, 2006). To the extent that household food insecurity compromises these parental well-being and behavior variables, such factors may link household food insecurity and child development. Household food insecurity may impact parental well-being and behaviors through parents’ own hunger and through psychological factors. Adult hunger is known to increase negative emotion, stress, and aggressive and punitive behavior (e.g., Bushman et al., 2014; MacCormack & Lindquist, 2019), suggesting that parents who bear the brunt of household food insecurity may be more depressed, stressed, and harsh with their partner and with their children. In turn, parental depression and stress, interparental conflict, and harsh parent–child interactions have been linked with worse child outcomes (e.g., Grych, 2002; Surkan et al., 2012). Psychological factors may also play a role. The family stress model (Conger & Elder, 1994) extended to the case of food insecurity implies that lack of access to resources such as food increases parental stress and depression, which decreases the quality of the parent–child relationship (Crnic et  al., 2005; Crnic & Low, 2002). Parents who are preoccupied with providing food for their children may be less sensitive and responsive to their child’s needs and behaviors, and engage in fewer activities known to stimulate cognitive and social development (Burchinal et  al., 2008). Parents in food insecure households may also experience shame, guilt, or

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stigma associated with being unable to provide sufficient food for the family (e.g., Belle & Doucet, 2003), which could cause them to be more withdrawn, distracted, and stressed—detracting from optimally supportive parent–child interactions (e.g., Crnic & Low, 2002; Crnic et  al., 2005). Finally, food insecurity—like resource deprivation more broadly—could sap parents’ executive functioning skills such as attention, planning, and working memory, if, for instance, the cognitive load of stretching a food budget is a persistent burden or distraction (Mani et al., 2013). This could, in turn, reduce parents’ abilities to engage in stimulating activities and to attend to their children in sustained, developmentally appropriate interactions. Indeed, a substantial body of research links household food insecurity to suboptimal parental well-being and behaviors. Food insecurity has been shown to increase parental stress and depression (Bronte-Tinkew et al., 2007; Melchior et al., 2009; Whitaker et al., 2006), with negative implications for interparental and parent–child interactions (Crnic et  al., 2005; Grych, 2002; Huang et  al., 2010; Zaslow et  al., 2009). Such findings are consistent with our own research which finds associations between early food insecurity and contemporaneous increases in maternal depression and parental arguing (Johnson & Markowitz, 2018b). What is not yet well understood, however, is whether and to what extent these identified parental well-being and behavior variables actually mediate documented associations between early childhood food insecurity and kindergarten school readiness skills. One previous study has demonstrated links between food insecurity, maternal depression and feeding behaviors, and cognitive development (Zaslow et al., 2009); however, this study looked only at food insecurity at 9 months, cognitive outcomes at 2 years, and two potential mediators—leaving unaddressed several avenues by which parental well-being and behavior may influence development. The current study builds on this work by including a broader set of potentially relevant mediators, and measuring outcomes at kindergarten, which are more predictive of later success.

Current Study and Hypotheses Using nationally representative data leveraged in other food insecurity research (e.g., Bronte-Tinkew et  al., 2007; Johnson & Markowitz, 2018a, 2018b; Zaslow et al., 2009), we pursue one overarching research question: do a range of empirically supported parent well-being and behavior factors mediate associations between early childhood food insecurity at age two and children’s cognitive and social-­ emotional school readiness skills in kindergarten? Within that aim, we replicate and extend previous research, testing several hypotheses on a low-income sample for whom food insecurity is more prevalent than among the general population. Specifically, we examine which parental well-being and behavior variables— including maternal depression, parent-reported cognitive stimulation in the home, parental arguing, maternal stress, and an observational measure of parenting— explain the largest proportion of the total association between household food insecurity in toddlerhood and children’s kindergarten outcomes. We look across

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developmental domains, separating children’s kindergarten cognitive (reading; math) and social-emotional skills (hyperactivity; conduct problems; approaches to learning). We expect maternal depression to be the strongest mediator, exerting a relatively equal influence across domains in light of substantial research linking maternal depression to both food insecurity and a host of child outcomes (e.g., Downey & Coyne, 1990; Surkan et al., 2012; Zaslow et al., 2009). We hypothesize that other variables related to “how parents feel,” such as self-reported parenting stress, will similarly mediate a substantial proportion of the link between food insecurity and child kindergarten skills, likely more so for social-emotional than cognitive skills, given prior literature linking parenting stress to children’s attachment quality and behavior (e.g., Crnic & Low, 2002; Crnic et al., 2005). Our hypotheses about mediators capturing “what parents do”—such as parental arguing and the quality of parent–child interactions—are more speculative. For instance, marital conflict has been linked to cross-domain outcomes (e.g., Cummings & Davies, 1994, 2002; Grych, 2002), as has parent–child interaction and home environment (Bradley et al., 2001; Petrill & Deater-Deckard, 2004).

Method Data and Sample Data were drawn from the Early Childhood Longitudinal Study–Birth Cohort (ECLS-B), a nationally representative study of children born in the U.S. in 2001. From a sample of over 14,000 live-birth certificates across 96 counties or county-­ clusters, approximately 10,700 children participated in the baseline wave of data collection. Mothers were interviewed and children were assessed in 2001 when they were 9 months old (wave 1); in 2003 when they were 2 years old (wave 2); in 2005–2006 when they were in preschool (age 4; wave 3); and in 2006–2007 when they were in kindergarten (wave 4). The current study uses data from all waves in order to ensure appropriate temporal ordering in our mediation analyses; response rates across all waves were about 90%. ECLS-B-constructed weights were applied to account for the study’s complex sampling design, oversampling of certain populations, and for survey nonresponse; the weighted sample is representative of all children born in the U.S. in 2001. Given that the low-income and food-insecure populations are highly overlapping, analyses focus on the subsample of children with valid food insecurity and outcome data whose household incomes were at or below 185% of the Federal Poverty Line (the income cutoff for the Special Supplemental Nutrition Program for Women, Infants, and Children [WIC]) at wave 2, the time point at which food insecurity is drawn. The low-income subsample included children with full information on food insecurity at 2 years and outcome data at kindergarten, and ranged in size from N ≈ 1450–2900, depending on outcome and mediator (see Table 1 for Ns by model and Ns rounded to the nearest 50 per data security requirements). Missing data on

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A. J. Markowitz et al.

Table 1  Descriptive statistics by household food insecurity status at 2 years All M Food insecurity in preschool  FI without hunger in preschool  FI with hunger in preschool Family well-being and behavior  Depressive symptoms  Cognitive stimulation in the home  Parenting stress  Frequency of parent arguing Kindergarten outcomes  Hyperactivity  Conduct problems  Approaches to learning  Language/literacy  Math Maternal characteristics  White  Black  Hispanic  Asian/other  Mother, less than HS  Mother, HS  Mother, some college  Mother, college or more  Mother is employed  Single mother  Immigrant  Fluent  Mother over 20 at birth

SD

Not FI at 2 years M SD

FI w/o hunger at 2 years M SD

FI w hunger at Not FI 2 years vs. FI M SD

0.17

0.14

0.38

0.28

***

0.05

0.03

0.11

0.25

***

6.13

6.06

5.60

5.56

8.45

7.13 10.81

9.27 ***

8.53

2.06

8.58

2.05

8.27

2.13

2.11

8.45

5.21 10.92

3.68 5.03 7.19 10.54

3.60 6.05 7.08 13.2

3.94 6.66 7.38 11.67

3.78 *** 8.52 **

11.32 7.36 14.82

4.62 11.21 3.38 7.28 3.15 14.93

4.57 11.54 3.36 7.46 3.13 14.4

4.87 13.44 3.40 8.97 3.31 13.68

4.65 + 3.78 2.71 *

39.17 13.65 39.64 40.37 9.84 40.81

13.58 36.46 9.72 38.23

14.01 37.51 10.25 37.38

13.1 *** 9.90 ***

0.38 0.22 0.34 0.06 0.35

0.37 0.22 0.35 0.06 0.34

0.42 0.22 0.32 0.04 0.43

0.36 0.15 0.32 0.16 0.36

0.38 0.23

0.39 0.23

0.31 0.24

0.38 0.21

*

0.04

0.04

0.02

0.04

+

0.42 0.32 0.28 0.81 0.82

0.43 0.31 0.28 0.81 0.82

0.34 0.34 0.28 0.78 0.81

0.38 0.35 0.27 0.81 0.89

*

*

(continued)

Food Insecurity in Toddlerhood and School Readiness…

17

Table 1 (continued)

Family characteristics  Lives in urban area  Family size  Number of children under 6  Number of children over 7  Received food assistance  Average income  Parental care only, 9 months  Home-based care, 9 months  Center-based care, 9 months  On-time kindergarten entry Child characteristics  Male  Child age in kindergarten (months)  Child has disability n

SD

Not FI at 2 years M SD

FI w/o hunger at 2 years M SD

FI w hunger at Not FI 2 years vs. FI M SD

0.69 4.13 0.78

1.40 0.86

0.70 4.11 0.77

1.42 0.87

0.68 4.21 0.85

1.32 0.84

0.69 4.12 0.83

1.35 0.81

0.69

1.02

0.68

1.02

0.68

1.03

0.69

1.00

All M

0.87 9.92 0.56

0.86 0.58

9.95 0.54

0.90 0.58

9.75 0.65

0.94 0.58

9.68 0.69

0.65 *** *** ***

0.38

0.40

0.28

0.25

0.06

0.06

0.06

0.06

0.74

0.74

0.74

0.83

0.52 68.04 4.44

0.52 68.06

0.07 3050

0.07 2550

4.47

0.56 67.96 0.08 400

4.28

*

0.53 67.66

4.48

0.11 100

Note. FI food insecure, HS high school. Data are drawn from the Early Childhood Longitudinal Study—Birth Cohort (ECLS-B) 9-month kindergarten restricted use data file. Sample is limited to low-income families defined as families with incomes ever at or below 185% of the Federal Poverty Line (FPL) at wave 2, with food insecurity data at wave 2, and children with data on at least one kindergarten outcome. Hyperactivity, conduct problems, and approaches to learning are weighted using jackknife replicate weights WK45T1-90; reading and math and maternal, family, and child characteristics are weighted using jackknife replicate weights WK1C1-90. Ns are rounded to the nearest 50 per NCES data security requirements. Income is measured as the natural log of the 3-year average family income; 9.95 is equivalent to approximately $21,000; 9.68 is equivalent to roughly $16,000 in 2002 dollars +p