From Poverty to Food Insecurity and Child Overweight: A Family Stress Approach

Food insecurity and child overweight represent major public health problems in the United States, especially for children living in poverty. Recent research has greatly expanded our knowledge regarding the antecedents of these health concerns, yet the causal mechanisms connecting poverty to food insecurity and to child overweight remain unclear. This article reviews the research through the perspective of family stress theory and proposes a developmental model to explain how poverty and its related economic stress affect specific parental resources and behaviors that, in turn, may account for food insecurity and overweight in young children. It proposes maternal depression and family food behaviors— such as the acquisition, provision, and distribution of food in the household—as key mediators linking poverty to food insecurity and child overweight. KEYWORDS—poverty; family stress theory; child overweight; food insecurity; maternal depression Poverty puts children at risk for a host of negative outcomes. Children in impoverished households are more likely than their peers in households with adequate resources to struggle academically, to display social and emotional problems, and to experience poor health (Brooks-Gunn & Duncan, 1997; McLeod & Shanahan, 1993). Although we do not yet fully know what mechanisms link poverty to poor child outcomes, family stress theory helps to explain how poverty, parenting, and child outcomes may be related (Conger & Elder, 1994; Conger et al., 2002). According to this theory, parents struggling to make ends meet because of lack of income, underemployment, and lowwage jobs experience heightened stress that leads to changes in emotions and behaviors that hurt their parenting and affect their children adversely (Conger, 2005; Conger et al., 2002). We argue that the family stress model, typically used to explain negative psychosocial and cognitive outcomes among poor children, has clear implications for understanding two prevalent child health issues: food insecurity and child overweight. Rates of food insecurity are disproportionately high among low-income families (Nord, Andrews, & Carlson, 2008). Food insecurity, defined as limited or uncertain access to sufficient and nutritious food, results from financial or social constraints that prevent the acquisition of adequate food in socially acceptable ways (Nord & Hopwood, 2007). Whereas about 11% of U.S. households report household food insecurity, 40% of poor households with young children (under age 6) had experienced food insecurity during the previous 12-month period (Nord et al., 2008). At the same time, childhood overweight and obesity have reached epidemic proportions in the United States (Tudor-Locke, Kronenfeld, Kim, Benin, & Kuby, 2007). Childhood obesity, defined as sexand age-specific body mass index (BMI) equal to or above the 95th percentile for children (American Academy of Pediatrics, 2003; Krebs et al., 2007), and child overweight (sexand age-specific BMI in the 85th to 95th percentiles) now substantially affect very young children. Just over 12% of all U.S. children ages 2–5 are obese (Ogden, Carroll, & Flegal, 2008). This trend is especially worrisome for low-income children, whose obesity rates have risen faster than those of the general child population (Anderson & Butcher, 2006). Studies report that between 31% and 33% of low-income preschool-aged children are overweight or obese, with sex-specific BMI-for-age at or above the 85th percentile (Edmunds et al., 2006; Kimbro, Brooks-Gunn, & McLanahan, 2007; Polhamus et al., 2009; Williams, Strobino, Bollella, & Brotanek, 2007), as compared to 24% of U.S. preschoolers in the general population (Ogden et al., 2008). In the remainder of this article, we use the term overweight to refer to both child overweight and obesity. Correspondence concerning this article should be addressed to Karen McCurdy, University of Rhode Island, 2 Lower College, Kingston, RI 02881; e-mail: [email protected]. a 2010, Copyright the Author(s) Journal Compilation a 2010, Society for Research in Child Development Volume 4, Number 2, Pages 144–151 CHILD DEVELOPMENT PERSPECTIVES