The primary goal of this  study was  to develop a comprehensive model to investigate whether food insecurity worked through child anemia to put children at risk for developmental problems.   The second goal of the study was to determine whether presence of maternal depression strengthened the relations food insecurity, anemia, and developmental risk model.  

Food insecurity is the inability to access enough food for an active and healthy life for all household members at all times. It is typically episodic in nature and disproportionately  affects low-income families from racial and ethnic minority backgrounds. Children from food insecure households are more likely to experience anemia (presumably from inadequate nutrition) and developmental risk compared with food secure children.  Caregivers who experience food insecurity are more likely to report depression, which may negatively impact their parenting effectiveness.

A low-income, African-American group of caregivers who sought care for their young children at an urban medical center were interviewed as part of the Children’s HealthWatch Research Project.  The current study utilized the self-report interview data, which provided caregiver responses to questions about developmental risk, caregiver depression, and food insecurity.  These responses were supplemented with medical record data on developmental risk and anemia.  The two sources of developmental risk data were combined into a developmental risk index. 

Relations among variables were examined using correlations, chi-square analyses, and logistic regressions.  Mediation, moderation, and moderated-mediation models were estimated in order to determine whether food insecurity, developmental risk, anemia, and maternal depression were related as hypothesized.

This study has two major findings.  First, child anemia was related to developmental risk such that children with developmental risk were more likely to be anemic compared with children who were not at developmental risk. When examined closely, the relation was strongest between parent’s report of developmental concern and anemia and did not reach significance when only the medical record sources of developmental risk were considered.  Second, mothers who reported food insecurity were also more likely to report depressive symptoms.

These findings highlight the need to screen for developmental risk by asking parents about their concerns, and incorporating a screening tool (e.g., the Parents’ Report of Developmental Status) into pediatric practice, especially one that is validated for use as parent report. It is also important to identify and intervene when families experience food insecurity, child anemia, and caregiver mental health problems.  Practitioners and programs that serve families can use a variety of techniques to screen caregivers for depressive symptoms and food insecurity and identify families in need of food or other resources to cope with economic hardships.  It is important to link families to services that may aid in decreasing those hardships and the worry associated with them, which may, in turn decrease a caregiver’s depressive symptoms. 

Psychologists would be wise to consider contextual factors influencing family functioning.  Experiences of food insecurity take a toll on caregiver mental health, which in turn decreases parenting effectiveness.  The current study supports the theory that the child’s context influences optimal development.  Experiences of food insecurity, maternal depression, and anemia may directly or indirectly influence family functioning and children’s psychosocial functioning and development.

Policy makers can improve child outcomes by increasing availability and access to public assistance programs including the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Program (formerly Food Stamps).  Investment early is not only the most economical way to improve the future of our society; it optimizes early childhood development and ensures that children grow to be productive members of society.